SCGB3A2 as a growth factor and anti-apoptotic agent

ABSTRACT

The present disclosure is generally related to methods of using the secretory protein SCGB3A2 for promoting lung development and treating lung disease. Some embodiments are, for example, methods for treating and inhibiting the development of neonatal respiratory distress. Other embodiments are methods of promoting lung development in damaged or diseased lungs. Also disclosed are methods for inhibiting lung damage due to anti-cancer agents.

PRIORITY CLAIM

This is a divisional of U.S. patent application Ser. No. 12/442,927,filed Mar. 25, 2009, now U.S. Pat. No. 8,133,859, which is the §371 U.S.national stage of PCT Application No. PCT/US2007/079771, filed Sep. 27,2007, which was published in English under PCT Article 21(2), which inturn claims the benefit of U.S. Provisional Patent Application No.60/847,747, filed Sep. 27, 2006, and U.S. Provisional Patent ApplicationNo. 60/880,134, filed Jan. 12, 2007. All of the prior filings areincorporated herein in their entirety.

FIELD

The present disclosure is generally related to methods of promoting lungdevelopment and treating lung disease, for example, methods for treatingand inhibiting the development of neonatal respiratory distress, methodsof promoting lung development, and methods for inhibiting lung damagedue to anti-cancer agents.

BACKGROUND

Neonatal respiratory distress syndrome (RDS), also called respiratorydistress syndrome of prematurity, is a syndrome caused by developmentallack of surfactant and structural immaturity in the lungs of prematureinfants. RDS affects about 1% of newborn infants. The incidencedecreases with advancing gestational age, from about 50% in babies bornat 26-28 weeks, to about 25% at 30-31 weeks. The syndrome is morefrequent in infants of diabetic mothers and in the second born ofpremature twins. Despite huge advances in care, RDS remains the mostcommon single cause of death in the first month of life. Complicationsinclude metabolic disorders (acidosis, low blood sugar), patent ductusarteriosus, low blood pressure, chronic lung changes, and intracranialhemorrhage.

Pulmonary fibrosis is a disease of inflammation that results inscarring, or fibrosis, of the lungs. In time, this fibrosis can build upto the point where the lungs are unable to provide oxygen to the tissuesof the body. The average survival rate for a subject with pulmonaryfibrosis is about four to six years after diagnosis. Pulmonary fibrosisis the most common side effect of certain anti-cancer agents, such ascytotoxic antibiotics.

Given the foregoing, it would be desirable to have effective methods fortreating or preventing neonatal respiratory distress syndrome, andmethods of inhibiting the development of pulmonary fibrosis resultingfrom exposure to anti-cancer agents such as cytotoxic antibiotics.

SUMMARY

Disclosed herein are methods for treating and inhibiting the developmentof neonatal respiratory distress, methods of promoting lung development,and methods of inhibiting or reducing lung damage that results fromtreatment with certain anti-cancer agents. These methods are based onthe surprising discovery that the secretory protein SCGB3A2 has bothgrowth factor and anti-apoptotic activities, in addition to itspreviously-known anti-inflammatory activities. Examples of these methodsare provided in the context of a specific example of a SCGB3A2 protein;however, other equivalents are contemplated.

One such method of treatment is a method for using SCGB3A2 to treat orinhibit the development of neonatal respiratory distress in a subject.In some embodiments, the SCGB3A2 is administered prenatally, and inother embodiments the SCGB3A2 is administered postnatally.

Also disclosed herein is a method of promoting lung development. Themethod includes contacting a lung cell with an effective amount ofSCGB3A2. In various embodiments the method is carried out in vitro,whereas in other embodiments the method is carried out in vivo.

Yet another method is disclosed for using SCGB3A2 to inhibit or reducelung damage in a subject being treated with an anti-cancer agent. Insome embodiments, the anticancer agent is a cytotoxic antibiotic, and inparticular examples, the anti-cancer agent is bleomycin.

The foregoing and other features will become more apparent from thefollowing detailed description of several embodiments, which proceedswith reference to the accompanying figures.

BRIEF DESCRIPTION OF THE FIGURES

FIGS. 1A-1J are a series of digital images showing immunohistochemistryand organ culture of murine fetal lungs at embryonic day 11.5 (E11.5).FIGS. 1A and 1B are digital images of immunohistochemistry for SCGB3A2(FIG. 1A) and TITF1 (FIG. 1B). Arrows indicate representative positivesignals. FIGS. 1C-J are digital images showing organ cultures. Fetallung is shown at E11.5 before culture (FIG. 1C), after 4-days culture incontrol media (FIG. 1D), in the presence of 50 ng/ml SCGB3A2 (FIG. 1E),in the presence of 250 ng/ml SCGB3A2 (FIG. 1F), in the presence of 50ng/ml SCGB3A2 and 2% SCGB3A2-specific antiserum (FIG. 1G), in thepresence of 250 ng/ml SCGB3A2 and 2% SCGB3A2-specific antiserum (FIG.1H), in the presence of 2% preimmune serum (FIG. 1I), and in thepresence of 2% SCGB3A2-specific antiserum (FIG. 1J). Scale bar: 0.5 mm.

FIGS. 2A-2J are a series of digital images showing morphological changesof E16.5 Titf1-null fetal lungs in the presence of SCGB3A2. FIGS. 2A-Fshow ex vivo cultured fetal lungs: dissecting microscopic observation ofTitf1-null lung (FIG. 2A), Titf1-null lung cultured with SCGB3A2 for 4days (FIG. 2B), Titf1-null lung cultured without SCGB3A2 for 4 days(FIG. 2C), hematoxylin and eosin (H&E) staining of tissue shown in FIG.2C (FIG. 2E) and FIG. 2B (FIGS. 2D and 2F). FIGS. 2G-J show thehistology of Titf1-null embryos: H&E staining of trachea without (FIG.2G) and with SCGB3A2 treatment (FIG. 2H), and lung without (FIG. 2I) andwith SCGB3A2 treatment (FIG. 2J). Inserts in FIGS. 2G and 2I showciliated cells that are infrequently seen in trachea and lung of nullfetus. Representative ciliated cells are shown by arrows in FIGS. 2G-J.Scale bar: (FIGS. 2A-C) 0.5 mm, (FIGS. 2D-F) 100 μm, (FIGS. 2G-J) 50 μm.

FIGS. 3A-3E are a series of graphs and digital images showing thatSCGB3A2 induces proliferation in E16.5 Titf1-null fetal lung. FIGS. 3A-Care graphs showing positive cell numbers for phosphorylated histone H3and Ki-67 immunostaining, counted in epithelial and mesenchymal cellsseparately or as a whole from ex vivo cultured Titf1-null fetal lung(FIG. 3A), and Titf1-null fetal lung and trachea (FIGS. 3B and 3C) withand without SCGB3A2 treatment, and are expressed in a bar graph with SD.(For examples of representative immunostaining results, see FIG. 7,below). *P<0.05, **P<0.01, ***P<0.005, ****P<0.001 by Student's t-test.FIG. 3D is a pair of digital images showing primary fetal lungmesenchymal cells that were treated with and without 10 μg/ml SCGB3A2,and were labeled with 10 μM bromodeoxyuridine (BrdU) for 1 hour andsubjected to fluorescent activated cell sorting (FACS) analysis.Representative results from three separate experiments for thedistribution of BrdU incorporation with and without SCGB3A2 treatmentare shown. For each sample, 10,000 cells were analyzed. Values are themean±SD. Note that upon treatment with SCGB3A2, more cells withincorporated BrdU were found (Gate 5, P<0.05). FIG. 3E is a series ofdigital images showing the RT-PCR analysis of ex vivo culturedTitf1-null lungs for the expression of FGFs with and without SCGB3A2treatment.

FIGS. 4A-4L are a series of digital images showing immunocytochemistryfor the possible presence of a SCGB3A2 receptor. Primary fetal lungepithelial and mesenchymal cells were treated with and without 10 μg/mlSCGB3A2 and were subjected to immunocytochemistry for MARCO (FIGS.4A-D), anti-histidine (His) (FIGS. 4E-H) and anti-thioredoxin (Trx)antibodies (FIGS. 4I-L). Positive signals (green fluorescence) are seenonly on the surface of SCGB3A2-treated mesenchymal cells in FIGS. 4H and4L. Scale bar: 50 μm.

FIGS. 5A-5H are a series of digital images showing expression of acandidate SCGB3A2 downstream target gene, Rad23b. Rad23b in situhybridization was carried out using normal fetal lungs at E13.5 (FIG.5A) and E16.5 (FIG. 5B), in Titf1-null trachea (FIGS. 5C and 5D) andlung (FIGS. 5E and 5F), and in organ cultured Titf1-null lungs (FIGS. 5Gand 5H) with and without SCGB3A2 in the media. In FIG. 5D, positivesignals are seen in the basal layers, shown by arrowheads. Br: bronchus,e: epithelia, m: mesenchyme. The insert in FIG. 5F shows the result withsense probe (ss). Scale bar: 100 μm.

FIGS. 6A-6H are a series of graphs and digital images showing the effectof Rad23b siRNA on branching of lung tissue. FIG. 6A shows the effect ofRad23b siRNA probes on the reduction of Rad23b mRNA levels in fetal lungprimary culture cells, examined by quantitative PCR. FIG. 6B shows theRT-PCR analysis for Rad23b expression using primary mesenchymal cellsisolated from E16.5 fetal lungs, cultured for 2 days with or withoutindicated siRNA in the presence or absence of SCGB3A2. FIGS. 6C-H showlung organ culture. E11.5 normal mouse fetal lungs were cultured for twodays in control media (FIG. 6C), in the presence of 250 ng/ml SCGB3A2(FIG. 6D), transfected with 50 nM negative siRNA (FIG. 6E), with 50 nMnegative siRNA in the presence of 250 ng/ml SCGB3A2 (FIG. 6F), with 50nM Rad23b siRNA probe 1 (FIG. 6G), with 50 nM Rad23b siRNA probe 1 inthe presence of 250 ng SCGB3A2. Scale bars: 0.5 mm.

FIGS. 7A-7L are a series of digital images showing immunohistochemistryfor phosphorylated histone H3 and Ki-67. FIGS. 7A-D show ex vivocultured fetal lungs with and without SCGB3A2 for four days.Phosphorylated histone H3 (FIGS. 7A and 7B) and Ki-67 (FIGS. 7C and 7D).FIGS. 7E-L show Titf1-null mouse with and without SCGB3A2 treatment.Trachea (FIGS. 7E, 7F, 7I, and 7J) and lung (FIGS. 7G, 7H, 7K, and 7L)were immunostained for phosphorylated histone H3 (FIGS. 7E-H) and Ki-67(FIGS. 7I-L). Inserts in FIGS. 7A and 7C show positive cells that arerarely seen. Inserts in FIGS. 7E, 7F, 7H, 7I, 7J, and 7L are magnifiedimages of the small squared areas. Black and red arrows pointrepresentative positive signals in epithelia and mesenchymes,respectively. Scale bar: 100 μm.

FIGS. 8A-8B are a pair of graphs showing terminal deoxynucleotidyltransferase mediated dUTP Nick End Labeling (TUNEL) analysis ofbleomycin-treated primary fetal lung mesenchymal cells. SCGB3A2 (250 ngor 1 μg) was added to the culture media together with (FIG. 8A) or 20hours earlier (FIG. 8B) than bleomycin (25 mU). TUNEL-positive cells arepresented as a percentage of total cells.

FIGS. 9A-9F are a graph and several digital images showing the effectsof SCGB3A2 in a mouse model for bleomycin-induced fibrosis. FIG. 9Ashows a graph of body weight changes over time. Bleomycin treatmentcaused a halt of body weight increase as compared with sham or phosphatebuffered saline (PBS) treated mice. FIGS. 9B, 9C, 9E, and 9F show theresults of H & E staining. FIG. 9D shows the results of Masson staining(MT) for detection of collagen fiber. After three weeks of bleomycintreatment (Bleo 3W), focal interstitial pneumonia and fibrosis developed(FIGS. 9C, 9D) whereas SCGB3A2-treated mouse lungs were mostly normalwith small area of fibrosis (FIG. 9E). Distal alveoli presented normalmorphology with the presence of occasional macrophages (shown byarrows), suggestive of healed injuries (FIG. 9F). Scale bar: 100 μm.

FIGS. 10A-10I are a graph and a series of digital images showing thatSCGB3A2 transgenic mice are resistant to bleomycin-induced lungfibrosis. FIG. 10A is a graph of body weight changes over time. SCGB3A2transgenic mice did not lose weight. FIGS. 10B and 10C show SCGB3A2immunostaining of wild-type (FIG. 10B) and SCGB3A2 transgenic mouselungs (FIG. 10C). In the latter mice, much higher expression of SCGB3A2was found in alveolar type II cells as compared with control (greyarrow). Black arrow: SCGB3A2 positive epithelial cells. FIGS. 10D-G, 10Ishow H&E staining. FIG. 10H shows Masson staining. Three weeks afterbleomycin treatment (Bleo 3W), fibrosis was produced in wild type mice(WT) as seen in FIG. 10D, 10F, and 10H, whereas SCGB3A2 transgenic mice(SCGB3A2 Tg) did not develop any fibrosis (FIGS. 10E, 10G, and 10I).Scale bar: FIGS. 10B, 10C, 10I: 50 μm; FIGS. 10D-H 100 μm.

FIG. 11 is a schematic diagram showing the design of the bleomycinexperiments described in Examples 11-14. Mice were intratracheallyadministered bleomycin or PBS at day 0, and SCGB3A2 or PBS was injectedintravenously daily for a week starting on day 14. All mice wereeuthanized on day 21. There are four groups: group 1—bleomycinadministration+PBS injection; group 2—bleomycin administration+SCGB3A2injection; group 3—PBS administration+PBS injection; and group 4—PBSadministration+SCGB3A2 injection.

FIG. 12 is a graph showing the grading of bleomycin-induced fibrosisusing H&E stained whole lung. Grading was carried out according to thecriteria as follows: grade 1 —0-25% of fibrous area per whole lung;grade 2—26-50% of fibrous area per whole lung; grade 3—51-75% of fibrousarea per whole lung; grade 4; 76-100% of fibrous area per whole lung;and grade±—no fibrosis but a few infiltration foci of lymphocytes or avery small granuloma (shown by gray circle). n=5. Open circle representseach lung. Black circle, average±SD. **P<0.005.

FIG. 13 is a series of digital images showing Masson trichrome stainingin whole lung. Representative staining from each group is shown.Collagen fiber was stained with blue color (representative shown by anarrow in groups 2-4). Scale bar: 100 μm.

FIG. 14 is a series of graphs showing inflammatory cell counts inbronchoalveolar lavage fluids; groups are as defined in the legend toFIG. 11. Results from 3-5 mice are shown with SD. *P<0.05, **P<0.01.

FIGS. 15A-E are a series of graphs and digital images demonstrating thatSCGB3A2 promotes lung development and inhibits the development ofneonatal respiratory distress in vivo. FIG. 15A is a series of graphsshowing the lung maturity assessment of treated and untreated mousepups. E17.5 and 19.5 pups were removed from mothers who had receivedPBS, 100 μg SCGB3A2, or 200 μg SCGB3A2, and were subjected to breathingscore assessment, body length, and body and lung weight measurements.The number of each cohort is as follows: 30 pups from four mothers forPBS-treated E17.5; 32 pups from four mothers for 100 μg SCGB3A2-treatedE17.5; 37 pups from five mothers for 200 μg SCGB3A2-treated E17.5; andseven pups from one mother for PBS-treated E19.0. The results are themean±SD. *P<0.05, **P<0.01, ***P<0.005 by Student's t-test. NS: notsignificant. FIG. 15B is a series of digital gross images of lungs fromPBS-treated and 200 μg SCGB3A2-treated E17.5 pups, and PBS-treated Day 0pups. FIG. 15C is a series of digital images showing histology of lungsfrom PBS, 100 μg SCGB3A2, and 200 μg SCGB3A2-treated E17.5 andPBS-treated E19.0 pups. FIG. 15D is a series of five graphs showingquantitative PCR (qPCR) analysis for the expression of surfactantprotein (SP)-A, SP-D, aquaporin 1 (AQP1), leptin receptor (OB-R), andRad23b genes expressed in lungs from PBS (n=9), 100 (n=14) and 200 μg(n=16) SCGB3A2-treated E17.5, and PBS-treated E19.0 (n=4) pups. Theresults are shown as the means±SD. *P<0.05, **P<0.01, ***P<0.005 byStudent's t-test. NS: not significant. FIG. 15E is a scatter plot of theprincipal components analysis (PCA) model on the lipidomes of amnioticfluid samples from PBS-treated control (E17.5 and E19.0), andSCGB3A2-treated mice (E17.5 from 100 and 200 μg). Each principalcomponent summarizes an independent latent variable detected by PCA. Thet[1] and t[2] values represent the scores of each sample in principalcomponent 1 and 2, respectively. Fitness (R² value) of the model to theacquired dataset is 0.553, and the prediction power (Q² value) of themodel is 0.242. Each point represents the average of combined amnioticfluids from 7-9 fetuses from a mother, due to volume availability.

SEQUENCES

The nucleic and amino acid sequences provided herein are shown usingstandard letter abbreviations for nucleotide bases, and three lettercode for amino acids, as defined in 37 C.F.R. 1.822. The SequenceListing is submitted as an ASCII text file in the form of the file named“Sequence.txt” (˜6 kb), which was created on Feb. 3, 2012, which isincorporated by reference herein. In the accompanying sequence listing:

SEQ ID NO: 1 is a sense Rad23b siRNA probe 1.

SEQ ID NO: 2 is an antisense Rad23b siRNA probe 1.

SEQ ID NO: 3 is a sense Rad23b siRNA probe 2.

SEQ ID NO: 4 is an antisense Rad23b siRNA probe 2.

SEQ ID NO: 5 is a negative sense siRNA.

SEQ ID NO: 6 is a negative sense siRNA.

SEQ ID NO: 7 is a Rad23b primer (forward).

SEQ ID NO: 8 is a Rad23b primer (reverse).

SEQ ID NO: 9 is an FGF2 primer (forward).

SEQ ID NO: 10 is an FGF2 primer (reverse.

SEQ ID NO: 11 is an FGF7 primer (forward).

SEQ ID NO: 12 is an FGF7 primer (reverse).

SEQ ID NO: 13 is an FGF9 primer (forward).

SEQ ID NO: 14 is an FGF9 primer (reverse).

SEQ ID NO: 15 is an FGF10 primer (forward).

SEQ ID NO: 16 is an FGF10 primer (reverse).

SEQ ID NO: 17 is an 18S primer (forward).

SEQ ID NO: 18 is an 18S primer (reverse).

SEQ ID NO: 19 is oligonucleotide L2575.

SEQ ID NO: 20 is oligonucleotide L2576.

SEQ ID NO: 21 is oligonucleotide L907.

SEQ ID NO: 22 is a linker amino acid sequence.

SEQ ID NO: 23 is an SP-A primer (forward).

SEQ ID NO: 24 is an SP-A primer (reverse).

SEQ ID NO: 25 is an SP-D primer (forward).

SEQ ID NO: 26 is an SP-D primer (reverse).

SEQ ID NO: 27 is an AQP1 primer (forward).

SEQ ID NO: 28 is an AQP1 primer (reverse).

SEQ ID NO: 29 is an OB-R primer (forward).

SEQ ID NO: 30 is an OB-R primer (reverse).

DETAILED DESCRIPTION OF SPECIFIC EMBODIMENTS

I. Overview of Several Embodiments

Disclosed herein are therapeutic methods that make use of the secretoryprotein SCGB3A2 and equivalents and analogs thereof. These methods arebased on the surprising discovery that SCGB3A2 has both growth factorand anti-apoptotic activities, in addition to its previously-knownanti-inflammatory activities.

Some embodiments are methods of treating or preventing neonatalrespiratory distress in a subject. These methods include administeringto the subject an effective amount of SCGB3A2, thereby treating orpreventing the neonatal respiratory distress. In certain examples ofthese methods, the SCGB3A2 is administered prenatally, for instancetransplacentally or amniotically. In other embodiments, the SCGB3A2 isadministered postnatally, for instance intravenously, intra-arterially,intra-peritoneally, subcutaneously, or by inhalation.

Other methods are methods of promoting lung development. These methodsinclude contacting a lung cell with an effective amount of SCGB3A2,thereby promoting lung development. In some examples of the methods,contacting the lung cell with an effective amount of SCGB3A2 occurs exvivo, and in particular examples the lung cell is in a component of anexplant. Still more particular examples include a further step oftransplanting the lung cell (or explant, for instance) into a subjectafter the cell is contacted with SCBG3A2. In other embodiments of themethods, contacting the lung cell with an effective amount of SCGB3A2occurs via administering the SCGB3A2 to a subject, for exampletransplacentally, amniotically, intravenously, intra-arterially,intra-peritoneally, subcutaneously, or by inhalation. In certainexamples, the subject has diminished lung capacity, and in moreparticular examples the subject is a neonate.

Also disclosed are methods of inhibiting or reducing lung damage in asubject being treated with an anti-cancer agent. These methods includeadministering to the subject an effective amount of SCGB3A2, therebyinhibiting lung damage caused by the anti-cancer agent. In certainembodiments of the method, the SCGB3A2 is administered intravenously,intra-arterially, intra-peritoneally, subcutaneously, or by inhalation,and in particular examples, the SCGB3A2 is administered in conjunctionwith the anti-cancer agent. In even more particular examples, theanti-cancer agent is a cytotoxic antibiotic, and in some instances, theanti-cancer agent is bleomycin. In certain examples, the lung damageincludes pulmonary fibrosis.

The methods disclosed herein are provided in the context of a specificexample SCGB3A2 protein, however, other equivalents are contemplated.For instance, animal equivalents of SCGB3A2 would be appropriate for usein veterinary situations, or in animal models of lung development,pulmonary fibrosis, and neonatal respiratory distress, and these andother equivalents also may be used in human therapies.

II. Abbreviations

-   -   ABVD: adriamycin, bleomycin, vinblastine, and dacarbazine    -   ALI acute lung injury    -   AQP1 aquaporin 1    -   ARDS acute respiratory distress syndrome    -   BAL bronchoalveolar lavage    -   BrdU: bromodeoxyuridine    -   COPD chronic obstructive pulmonary disease    -   CPAP continuous positive airway pressure    -   FACS: fluorescent activated cell sorting    -   FBS fetal bovine serum    -   FEF forced expiratory flow    -   FEV1 forced expired volume in one second    -   FGF Fibroblast growth factor    -   FVC forced vital capacity    -   H & E hematoxylin and eosin    -   IMAC Immobilized Metal Ion Affinity Chromatography    -   IPTG isopropyl-β-D-thiogalactopyranoside    -   MARCO macrophage scavenger receptor with collagenous structure    -   MMEFR maximal midexpiratory rate    -   OB-R leptin receptor    -   PBS phosphate-buffered saline    -   PCA principal components analysis    -   PFA paraformaldehyde    -   PEFR peak expiratory flow rate    -   qPCR quantitative PCR    -   RDS respiratory distress syndrome    -   SP surfactant protein    -   TEV Tobacco Etch Virus    -   TUNEL: terminal deoxynucleotidyl transferase mediated dUTP Nick        End Labeling assay    -   UGRP1 uteroglobin-related protein 1    -   XPC xeroderma pigmentosum group C        III. Explanation of Terms

Unless otherwise noted, technical terms are used according toconventional usage. Definitions of common terms in molecular biology maybe found in Benjamin Lewin, Genes V, published by Oxford UniversityPress, 1994 (ISBN 0-19-854287-9); Kendrew et al. (eds.), TheEncyclopedia of Molecular Biology, published by Blackwell Science Ltd.,1994 (ISBN 0-632-02182-9); and Robert A. Meyers (ed.), Molecular Biologyand Biotechnology: a Comprehensive Desk Reference, published by VCHPublishers, Inc., 1995 (ISBN 1-56081-569-8).

In order to facilitate review of the various embodiments of thedisclosure, the following explanation of terms is provided:

Acute respiratory distress syndrome (ARDS): An inflammatory lung diseasecharacterized by acute hypoxemia respiratory failure due to pulmonaryedema (reviewed in Honing & Ingram, in: Harrison's Principles ofInternal Medicine, 14th Edition, A. S. Fauci, et al. (eds.),McGraw-Hill, N.Y., pp. 1483-1486, 1998; and Goodman et al., Am J.Respir. Crit. Care Med. 154:602-11, 1996). ARDS represents a spectrum ofresponses to acute lung injury (ALI); these responses occur ascomplications of a more widespread systemic response to acuteinflammation or injury.

ALI develops rapidly after a predisposing condition triggers a systemicinflammatory response, and is most strongly associated with conditionsthat produce direct alveolar injury or direct injury via the pulmonarycapillary bed, such as aspiration, diffuse infection, toxic inhalation,direct injury to the alveolar epithelium, or sepsis syndrome. ALI is theconsequence of unregulated over-expression of usual systemicinflammatory responses to infection and/or injury. Injury involves thealveolar epithelium and the pulmonary capillary endothelium, and resultsin a complex cascade of events. Injury is produced by cellular eventsassociated with neutrophils, macrophages, monocytes, and lymphocytesproducing various cytokines, in turn producing cellular activation,chemotaxis, and adhesion.

ARDS can be distinguished from neonatal respiratory distress syndrome,which occurs in newborn infants, and which is a consequence of lungimmaturity and lack of sufficient lung surfactant.

Amniotic administration: Administration (to the fetus) via the amnioticfluid. In amniotic administration, an agent is administered maternally,and is absorbed by the fetus from the amniotic fluid. In some examples,an agent is absorbed through fetal skin, and in other examples, it isabsorbed through the lungs. Administration to the mother of a compoundthat is to be delivered to a fetus via amniotic administration includesboth oral and parenteral routes of administration, and can includedirect injection or infusion into the amniotic sac.

Animal: Living multi-cellular vertebrate organisms, a category thatincludes, for example, mammals and birds. The term mammal includes bothhuman and non-human mammals. Similarly, the term “subject” includes bothhuman and veterinary subjects. Therefore, the general term “subject” isunderstood to include all animals, including, but not limited to,humans, or veterinary subjects, such as other primates, dogs, cats,horses, and cows.

Anti-cancer agent: An anti-neoplastic agent. Anti-cancer agents include,but are not limited to alkylating agents, such as nitrogen mustards (forexample, chlorambucil, chlormethine, cyclophosphamide, ifosfamide, andmelphalan), nitrosoureas (for example, carmustine, fotemustine,lomustine, and streptozocin), platinum compounds (for example,carboplatin, cisplatin, oxaliplatin, and bbr3464), busulfan,dacarbazine, mechlorethamine, procarbazine, temozolomide, thiotepa, anduramustine; antimetabolites, such as folic acid (for example,methotrexate, pemetrexed, and raltitrexed), purine (for example,cladribine, clofarabine, fludarabine, mercaptopurine, and tioguanine),pyrimidine (for example, capecitabine), cytarabine, fluorouracil, andgemcitabine; plant alkaloids, such as podophyllum (for example,etoposide, and teniposide), taxane (for example, docetaxel andpaclitaxel), vinca (for example, vinblastine, vincristine, vindesine,and vinorelbine); cytotoxic/antitumor antibiotics, such as anthracyclinefamily members (for example, daunorubicin, doxorubicin, epirubicin,idarubicin, mitoxantrone, and valrubicin), bleomycin, hydroxyurea, andmitomycin; topoisomerase inhibitors, such as topotecan and irinotecan;monoclonal antibodies, such as alemtuzumab, bevacizumab, cetuximab,gemtuzumab, rituximab, and trastuzumab; photosensitizers, such asaminolevulinic acid, methyl aminolevulinate, porfimer sodium, andverteporfin; and other agents , such as alitretinoin, altretamine,amsacrine, anagrelide, arsenic trioxide, asparaginase, bexarotene,bortezomib, celecoxib, denileukin diftitox, erlotinib, estramustine,gefitinib, hydroxycarbamide, imatinib, pentostatin, masoprocol,mitotane, pegaspargase, and tretinoin.

Apoptosis: A process of cellular suicide. Apoptosis is one of the maintypes of programmed cell death, and involves an orchestrated series ofbiochemical events leading to a characteristic cell morphology anddeath. The apoptotic process is executed in such a way as to safelydispose of cellular debris.

In contrast to necrosis, which is a form of traumatic cell death thatresults from acute cellular injury, apoptosis is carried out in anorderly process that generally confers advantages during an organism'slife cycle. For example, the differentiation of fingers and toes in adeveloping human embryo requires cells between the fingers to initiateapoptosis so that the digits can separate. Between 50 billion and 70billion cells die each day due to apoptosis in the average human adult.For an average child between the ages of 8 to 14, approximately 20billion to 30 billion cells die a day.

Defective apoptotic processes have been implicated in an extensivevariety of diseases. Excessive apoptosis causes hypotrophy, such as inischemic damage, whereas an insufficient amount results in uncontrolledcell proliferation, such as cancer.

Bleomycin: A glycosylated linear nonribosomal peptide antibioticproduced by the bacterium Streptomyces verticillus. More generally, theterm bleomycin refers to a family of structurally related compounds.When used as an anti-cancer agent, the chemotherapeutical forms areprimarily bleomycin A2 and B2. The drug is used in the treatment ofHodgkin's lymphoma (as a component of the adriamycin, bleomycin,vinblastine and dacarbazine (ABVD) regimen), squamous cell carcinomas,and testicular cancer as well as pleurodesis, for instance.

A serious complication of bleomycin treatment is pulmonary fibrosis,which is an inflammatory disease that results in scarring, or fibrosis,of the lungs. In time, this fibrosis can build up to the point where thelungs are unable to provide sufficient oxygen to the tissues of thebody. Pulmonary fibrosis sets off a series of events in which theinflammation and immune activity in the lungs, and eventually thefibrosis processes, become uncontrollable.

Bronchodilator: An antispasmodic or other agent that dilates a bronchusor bronchiole. Bronchodilators relax the smooth muscles of the airways,allowing the airway to dilate. Bronchodilator medicines do notcounteract inflammation.

Chronic Bronchitis: An inflammatory lung disease that results in along-standing inflammation of the airways that produces a lot of mucus,causing wheezing and infections. It is considered chronic if a subjecthas coughing and mucus on a regular basis for at least three months ayear and for two years in a row.

Chronic Obstructive Pulmonary Disease (COPD): A lung disease thatencompasses two closely related respiratory disorders that cause gradualloss of pulmonary function: chronic bronchitis and emphysema. A subjectwith COPD sometimes has both chronic bronchitis and emphysema, or mayjust have one of these diseases. Emphysema is an inflammatory lungdisease that destroys the alveolae and/or bronchae. Over time, the lungslose elasticity. This causes the air sacs to become enlarged, thusmaking breathing difficult.

In the beginning stages of COPD, a subject may have only a mildshortness of breath and occasional coughing spells. Initial symptoms caninclude a general feeling of illness, increasing shortness of breath,coughing, and wheezing. But, as the disease progresses, symptoms becomeincreasingly more severe.

The overwhelming cause of COPD is smoking. Approximately 90% of COPDsubjects have a history of smoking. In addition, untreated orunder-treated asthma may lead to irreversible lung damage. Thesesubjects may have symptoms similar to COPD.

Cystic Fibrosis An inflammatory lung disease that also affects the lungsand digestive systems, especially the pancreas. It causes the exocrineglands, which produce mucus and sweat, to produce abnormal secretions.Cystic fibrosis causes the cells in the lung tissue to produce anabnormal amount of thick, sticky mucus that clogs the airways of thelungs, resulting in pulmonary obstructions and life-threateningbacterial infections.

Cytotoxic antibiotic: A class of anti-cancer drugs that includesanthracycline family members (for example, daunorubicin, doxorubicin,epirubicin, idarubicin, mitoxantrone, and valrubicin), bleomycin,hydroxyurea, and mitomycin. The most serious complication of treatmentwith cytotoxic antibiotics is pulmonary fibrosis, which is aninflammatory disease that results in scarring, or fibrosis, of thelungs. In time, this fibrosis can build up to the point where the lungsare unable to provide oxygen to the tissues of the body. Pulmonaryfibrosis sets off a series of events in which the inflammation andimmune activity in the lungs, and eventually the fibrosis processes,become uncontrollable.

DNA (deoxyribonucleic acid): DNA is a long chain polymer which comprisesthe genetic material of most living organisms (some viruses have genescomprising ribonucleic acid (RNA)). The repeating units in DNA polymersare four different nucleotides, each of which comprises one of the fourbases, adenine, guanine, cytosine and thymine bound to a deoxyribosesugar to which a phosphate group is attached. Triplets of nucleotides(referred to as codons) code for each amino acid in a polypeptide, orfor a stop signal. The term codon is also used for the corresponding(and complementary) sequences of three nucleotides in the mRNA intowhich the DNA sequence is transcribed.

Unless otherwise specified, any reference to a DNA molecule is intendedto include the reverse complement of that DNA molecule. Thus, areference to the nucleic acid molecule that encodes SCGB3A2 (forinstance, UGRP1 type A mRNA: AF274959, type B mRNA: AF274960, type CmRNA: AF274961, mUGRP2: AF313456, EST AI391046, hUGRP1: AF313455, ESTAI355612, EST AI355302, and hUGRP2: AF313458, EST AW974727), or afragment thereof, encompasses both the sense strand and its reversecomplement. Thus, for instance, it is appropriate to generate probes orprimers from the reverse complement sequence of the disclosed nucleicacid molecules.

Expectorant: A drug or chemical substance that induces the ejection ofmucus, phlegm, and other fluids from the lungs and air passages, forexample by coughing.

Expiratory Flow Rate: The rate at which air is expelled from the lungsduring exhalation. A subject's maximum expiratory flow is measured by asimple pulmonary test; in performing the test, a subject first takes asdeep a breath as possible, then exhales as rapidly and as completely aspossible into a machine known as a spirometer, which measures the rateof exhalation. Forced expiratory flow 25-75 (FEF 25-75) is a measurementof the forced expiratory flow determined over the midportion of a forcedexhalation. An increase in the forced expiratory flow (FEF) or FEF 25-75reflects a decrease in bronchoconstriction and an improvement inpulmonary function.

Forced Expiratory Volume (FEV; FEV1): The volume of air resulting fromthe forced expiratory flow test, in which a subject first inspiresmaximally to the total lung capacity, then exhales as rapidly and ascompletely as possible. The forced expired volume in one second (FEV1)represents the maximum expiratory air volume a subject can produceduring a one-second interval. An increase in FEV or FEV1 reflects adecrease in bronchoconstriction and an improvement in pulmonaryfunction.

Forced Vital Capacity (FVC): The volume of air resulting from the forcedexpiratory flow test, in which a subject first inspires maximally to thetotal lung capacity, then exhales as rapidly and as completely aspossible. An increase in FVC reflects a decrease in bronchoconstrictionand an improvement in pulmonary function.

Growth factor: A protein capable of stimulating cellular proliferation,differentiation, and/or commitment. The term growth factor is sometimesused interchangeably with the term cytokine. Historically, cytokineswere associated with hematopoietic (blood forming) cells and immunesystem cells (for instance, lymphocytes and tissue cells from spleen,thymus, and lymph nodes). However, some of the same signaling proteinsused by the hematopoietic and immune systems are used by other cells andtissues, both during development and in the mature organism.

Some specific, non-limiting examples of growth factors includeTransforming growth factor beta (TGF-β), Granulocyte-colony stimulatingfactor (G-CSF), Granulocyte-macrophage colony stimulating factor(GM-CSF), nerve growth factor (NGF), Neurotrophins (for instance, NGF,BDNF, and NT3), Platelet-derived growth factor (PDGF), Erythropoietin(EPO), Thrombopoietin (TPO), Myostatin (GDF-8), Growth differentiationfactor-9 (GDF9), Basic fibroblast growth factor (bFGF or FGF2),Epidermal growth factor (EGF), Hepatocyte growth factor (HGF), and, asdescribed herein, SCGB3A2.

Glucocorticoid: A class of steroid hormones characterized by an abilityto bind with the cortisol receptor and trigger similar effects.Glucocorticoids have potent anti-inflammatory and immunosuppressiveproperties. As a consequence, glucocorticoids are widely used as drugsto treat inflammatory conditions such as inflammatory lung diseases. Inaddition, glucocorticoids have multiple effects on fetal development,including promoting maturation of the lung and production of thesurfactant necessary for extrauterine lung function. Thus, they areoften administered to women in pre-term labor in order to attempt tospeed lung maturation in a pre-term infant.

Specific, non-limiting examples of glucocorticoids includehydrocortisone, cortisone acetate, prednisone, prednisolone,methylprednisolone, dexamethasone, betamethasone, triamcinolone,beclometasone, fludrocortisone acetate, deoxycorticosterone acetate, andaldosterone.

Inflammatory lung disease: A disease of the lung that is associated withlung inflammation. In many inflammatory lung diseases, the inflammatoryresponse that accompanies the underlying disease state is much moredangerous than the underlying infection or trauma. Inflammatory lungdiseases can include, but are not limited to pneumonia, ARDS, chronicbronchitis, chronic obstructive pulmonary disease (COPD), cysticfibrosis, pulmonary fibrosis, and pulmonary sarcoidosis. For thepurposes of this disclosure, the term inflammatory lung disease does notinclude neonatal respiratory distress syndrome, which is a conditioninvolving lung immaturity and lack of surfactants.

Inspiratory Flow Rate: The rate at which air travels into the lungsduring inspiration. Inspiratory flow is measured by a simple pulmonarytest; in performing the test the subject takes as deep and rapid abreath as possible from a machine known as a spirometer, which measuresthe rate of inspiration. An increase in inspiratory flow rate reflects adecrease in bronchoconstriction and an improvement in pulmonaryfunction.

Isolated: An “isolated” biological component (such as a nucleic acidmolecule, protein or organelle) has been substantially separated orpurified away from other biological components in the cell of theorganism in which the component naturally occurs, i.e., otherchromosomal and extra-chromosomal DNA and RNA, proteins and organelles.Nucleic acids and proteins that have been “isolated” include nucleicacids and proteins purified by standard purification methods. The termalso embraces nucleic acids and proteins prepared by recombinantexpression in a host cell as well as chemically synthesized nucleicacids.

Lung damage: Damage or insult to the lungs or respiratory system. Lungdamage includes direct airway or alveolar injury or direct injury viathe pulmonary capillary bed, such as aspiration, diffuse infection,toxic inhalation, direct injury to the alveolar epithelium, or sepsissyndrome. Lung damage also includes lung-related drug effects, such asthe pulmonary fibrosis that can result from exposure to certainanti-cancer agents, such as the cytotoxic antibiotic bleomycin.

Lung Volume: The maximum volume the lungs can hold.

Nanoparticles: Solid colloidal particles that range in size from about10-1000 nm. They can be made from biodegradable and biocompatiblebiomaterials. Active components, such as drugs, can be adsorbed,encapsulated, or covalently attached to their surface or into theirmatrix.

Neonate: A human or animal infant less than about a month old. The term“neonate” includes premature infants and postmature infants, as well asfull term newborns.

Neonatal Respiratory Distress: Also called respiratory distress ofprematurity and respiratory distress syndrome (RDS), neonatalrespiratory distress results from a lack of pulmonary surfactant, amolecular substance that helps the lung's alveoli (air sacs) do theirjob of extracting carbon dioxide from the blood and replacing it withoxygen. The surfactant prevents the lung's alveoli from collapsing andhelps keep them properly inflated by reducing their surface tension. Theabsence of surfactant prevents the alveoli from functioning properly.RDS affects about 1% of newborn infants. The incidence decreases withadvancing gestational age (length of pregnancy), from about 50% inbabies born at 26-28 weeks, to about 25% at 30-31 weeks. The syndrome ismore frequent in infants of diabetic mothers and in the second born ofpremature twins.

Respiratory distress syndrome begins shortly after birth, and ismanifested by tachypnea and “sucking in” (retractions) of the chest wallduring breathing efforts (respiratory distress). In addition gruntingrespirations, flaring of the nostrils and cyanosis (a blue discolorationof the skin due to low oxygen content in the blood) are frequent. As thedisease progresses, the neonate may develop ventilatory failure(climbing carbon dioxide concentrations in the blood), and prolongedcessations of breathing (“apnea”). Whether treated or not, the clinicalcourse for the acute disease lasts about two to three days. During thefirst, the patient worsens and requires more support. During the secondthe subject may be remarkably stable on adequate support and resolutionis noted during the third day, heralded by a prompt diuresis. Despitehuge advances in care, RDS remains the most common single cause of deathin the first month of life. Complications include metabolic disorders(acidosis, low blood sugar), patent ductus arteriosus, low bloodpressure, chronic lung changes, and intracranial hemorrhage.

The lungs of an infant with RDS are developmentally deficient in amaterial called surfactant, which allows the alveoli to remain openthroughout the normal cycle of inhalation and exhalation. Surfactant isa complex system of lipids, proteins and glycoproteins which areproduced in specialized lung cells called Type II cells or Type IIpneumocytes. The surfactant is packaged by the cell in structures calledlamellar bodies, and extruded into the alveoli. The lamellar bodies thenunfold into a complex lining of the alveoli. This layer serves thepurpose of reducing the surface tension which would tend to cause thealveoli to collapse in the presence of gas. Without adequate amounts ofsurfactant, the alveoli collapse and are very difficult to expand.

Structural immaturity, as manifested by low numbers of alveoli, alsocontributes to the disease process. Additionally, the oxygen andbreathing treatments used, while life-saving, can also damage the lungs.The diagnosis of RDS is made by the clinical picture and the chestx-ray, which demonstrates decreased lung volumes (bell-shaped chest),absence of the thymus (after about six hours), a small (0.5-1 mm),discrete, uniform infiltrate involving all lobes of the lung andair-bronchograms. In severe cases, this becomes exaggerated until thecardiac borders become inapparent (‘white-out’ or ‘ground-glass’).

Parenteral: Administered outside of the intestine, e.g., not via thealimentary tract. Generally, parenteral formulations are those that willbe administered through any possible mode except ingestion. This termespecially refers to injections, whether administered amniotically,transplacentally, intravenously, intrathecally, intramuscularly,intraperitoneally, intra-articularly, or subcutaneously, and varioussurface applications including intranasal, inhalational, intradermal,and topical application, for instance.

Pharmaceutically acceptable carriers: The pharmaceutically acceptablecarriers useful in this disclosure are conventional. Martin, Remington'sPharmaceutical Sciences, published by Mack Publishing Co., Easton, Pa.,19th Edition, 1995, describes compositions and formulations suitable forpharmaceutical delivery of, for instance SCGB3A2.

In general, the nature of the carrier will depend on the particular modeof administration being employed. For instance, parenteral formulationsusually comprise injectable fluids that include pharmaceutically andphysiologically acceptable fluids such as water, physiological saline,balanced salt solutions, aqueous dextrose, glycerol or the like as avehicle. For solid compositions (e.g., powder, pill, tablet, or capsuleforms), conventional non-toxic solid carriers can include, for example,pharmaceutical grades of mannitol, lactose, starch, or magnesiumstearate. In addition to biologically-neutral carriers, pharmaceuticalcompositions to be administered can contain minor amounts of non-toxicauxiliary substances, such as wetting or emulsifying agents,preservatives, and pH buffering agents and the like, for example sodiumacetate or sorbitan monolaurate.

Pneumonia: An inflammatory lung disease characterized by inflammationand consolidation followed by resolution and caused by infection fromviruses, fungi, or physical and chemical irritants or bacteriaincluding: Pneumonococcus, Streptococcus, Hemolyticus, Staphylococcus,Friedländer's bacillus, and influenza bacillus. Symptoms include highfever, chest pain, difficulty breathing, coughing and sputum.

Preventing or treating a disease: “Preventing” a disease refers toinhibiting the full development of a disease, for example in a personwho is at risk for a disease such as neonatal respiratory distress orbleomycin-induced pulmonary fibrosis. An example of a subject at riskfor neonatal respiratory distress is a neonate born at less than fortyweeks' gestation, a fetus at risk of premature birth, or a fetus orneonate born to a mother with a condition that may cause delayed lungdevelopment, such as diabetes. An example of a subject at risk fordeveloping pulmonary fibrosis is someone who has begun or will begintreatment with an anti-cancer agent that can cause pulmonary fibrosis,such as bleomycin. “Treatment” refers to a therapeutic intervention thatameliorates a sign or symptom of a disease or pathological conditionafter it has begun to develop.

Pulmonary Fibrosis: An inflammatory lung disease that results inscarring, or fibrosis, of the lungs. In time, this fibrosis can build upto the point where the lungs are unable to provide oxygen to the tissuesof the body. Pulmonary fibrosis can result from an autoimmune disorder,the after effects of an infection, such as a viral infection, or fromexposure to certain anti-cancer agents, such as cytotoxic antibiotics. Aspecific example of an anti-cancer agent that can cause pulmonaryfibrosis is bleomycin.

Pulmonary fibrosis sets off a series of events in which the inflammationand immune activity in the lungs, and eventually the fibrosis processes,become uncontrollable. The average survival rate for a subject withpulmonary fibrosis is about four to six years after diagnosis. Those whodevelop pulmonary fibrosis at a young age seem to have a longer survivalthan those who develop it later in life.

Pulmonary function: The function of the respiratory system, which can bemeasured through a variety of tests, including, but not limited tomeasurements of airflow (e.g. spirometry) or arterial blood gases.Measurements of airflow included airflow rate, peak expiratory flow rate(PEFR), forced expiratory volume in the first second (FEV₁), and maximalmidexpiratory rate (MMEFR).

Purified: The term “purified” does not require absolute purity; rather,it is intended as a relative term. Thus, for example, a purified proteinpreparation is one in which the protein referred to is more pure thanthe protein in its natural environment within a cell or within aproduction reaction chamber (as appropriate).

Rad23b: One of the two Mus musculus homologs of the Saccharomycescerevisiae DNA repair protein RAD23. Rad23b is tightly complexed withxeroderma pigmentosum group C(XPC), serving as a primary DNA damagesensor.

Respiratory Disorder: A large variety of abnormalities arising in allstructures of the body involved with gas exchange. These structuresinclude the lungs, nose, oropharynx, extrapulmonary airways, thoraciccage, and respiratory muscles. Respiratory disorders encompass bothacute and chronic diseases. Asthma is one specific, non-limiting exampleof a respiratory disorder. Other specific, non-limiting examples includecoughs, pneumonia, bronchitis (for example, chronic obstructivebronchitis), neonatal respiratory distress, pulmonary fibrosis,emphysema, interstitial lung disease, cystic fibrosis, and lung tumors.

SCGB3A2: Also called uteroglobin-related protein 1 (UGRP1), LuLeul,1u103, Pnsp1, and Hin-2, SCGB3A2 is a member of the uteroglobin/Claracell secretory protein (UG/CCSP) gene superfamily of secretory proteins,and is predominantly expressed in the epithelial cells of trachea,bronchus, and bronchioles. SCGB3A2 has been shown to suppress lunginflammation using a mouse model for allergic airway inflammation (Chibaet al., (2006) Am. J. Respir. Crit. Care Med May 1; 173(9):958-64.).MARCO, a macrophage scavenger receptor that is expressed in lungalveolar macrophages and is involved in pulmonary inflammation, has beenidentified as the receptor for SCGB3A2 (Bin et al., (2003) J. Immunol.171, 924-30).

As used herein, the term “SCGB3A2” is intended generally. Thus, in oneembodiment, SCGB3A2 is a human protein. In another embodiment, SCGB3A2is a non-human animal homolog/ortholog of the human molecule, such as asheep, chimpanzee, goat, pig, mouse, rat, or hamster SCGB3A2-equivalentprotein.

The human SCGB3A2 gene is about 2,900 base pairs in length and consistsof three exons. The first intron of SCGB3A2 is about five to six-foldlonger than the second intron, which resembles the structure oforthologous mouse SCGB3A2 gene. Specific, non-limiting examples ofSCGB3A2 nucleotide sequences include the following GenBank accessionnumbers; UGRP1 type A mRNA: AF274959, type B mRNA: AF274960, type CmRNA: AF274961, mUGRP2: AF313456, EST AI391046, hUGRP1: AF313455, ESTAI355612, EST AI355302, and hUGRP2: AF313458, EST AW974727. One ofordinary skill in the art will recognize that these are provided merelyas examples; other proteins/nucleic acids that fall into the describedclass will be recognized.

Stem Cells Primal cells found in all multi-cellular organisms. Stemcells retain the ability to renew themselves through mitotic celldivision and can differentiate into a diverse range of specialized celltypes. The three broad categories of mammalian stem cells are: embryonicstem cells, which are derived from blastocysts; adult stem cells, whichare found in adult tissues; and cord blood stem cells, which are foundin the umbilical cord. In a developing embryo, stem cells candifferentiate into all of the specialized embryonic tissues. In adultorganisms, stem cells and progenitor cells act as a repair system forthe body, replenishing specialized cells.

By definition, stem cells possess two properties: self-renewal, theability to go through numerous cycles of cell division while maintainingthe undifferentiated state; and unlimited potency, the capacity todifferentiate into any mature cell type. In a strict sense, thisrequires stem cells to be either totipotent or pluripotent, althoughsome multipotent and/or unipotent progenitor cells are sometimesreferred to as stem cells.

Potency specifies the differentiation potential (the potential todifferentiate into different cell types) of the stem cell. Pluripotent,embryonic stem cells originate as inner mass cells within a blastocyst.These stem cells can become any tissue in the body, excluding aplacenta. Only the morula's cells are totipotent, able to become alltissues and a placenta. Totipotent stem cells are produced from thefusion of an egg and sperm cell. Cells produced by the first fewdivisions of the fertilized egg are also totipotent. These cells candifferentiate into embryonic and extraembryonic cell types. Pluripotentstem cells are the descendants of totipotent cells and can differentiateinto cells derived from any of the three germ layers.

Multipotent stem cells can produce only cells of a closely relatedfamily of cells (for instance, hematopoietic stem cells differentiateinto red blood cells, white blood cells, platelets, etc.). Unipotentcells can produce only one cell type, but have the property ofself-renewal, which distinguishes them from non-stem cells.

The term progenitor cell refers to immature or undifferentiated cells,typically found in postnatal animals. While progenitor cells share manycommon features with stem cells, the term is far less restrictive. Likestem cells, progenitor cells have a capacity for self-renewal anddifferentiation, although these properties may be limited. The majorityof progenitor cells lie dormant or possess little activity in the tissuein which they reside. They exhibit slow growth and their main role is toreplace cells lost by normal attrition. Upon tissue damage or injury,progenitor cells can be activated by growth factors or cytokines,leading to increased cell division important for the repair process.

Subject: Living multi-cellular vertebrate organisms, a category thatincludes both human and non-human mammals. The methods disclosed hereinhave equal applications in medical and veterinary settings. Therefore,the general term “subject” is understood to include all animals,including, but not limited to, humans or veterinary subjects, such asother primates, dogs, cats, horses, and cows.

Therapeutically effective amount: A quantity of a specified compound(such as SCGB3A2 or an equivalent thereof) required to achieve a desiredeffect in a subject being treated. For instance, this can be the amountnecessary to treat or prevent neonatal respiratory distress orbleomycin-induced pulmonary fibrosis in a subject, or a dose sufficientto prevent advancement, or to cause regression of a disease, or which iscapable of relieving symptoms caused by a disease, such as pain, lunginflammation, fluid accumulation, or shortness of breath.

Transplacental administration: Administration of an agent to a fetus viathe placenta. The agent can be administered to the mother via any routeof administration, including topical, oral, and parenteral routes ofadministration. An agent that is administered by transplacentaladministration crosses from the maternal bloodstream, across theplacenta, and into the fetal bloodstream.

Unless otherwise explained, all technical and scientific terms usedherein have the same meaning as commonly understood by one of ordinaryskill in the art to which this disclosure belongs. The singular terms“a”, “an”, and “the” include plural referents unless context clearlyindicates otherwise. Although methods and materials similar orequivalent to those described herein can be used in the practice ortesting of the present disclosure, suitable methods and materials aredescribed below. In case of conflict, the present specification,including terms, will control. In addition, the materials, methods, andexamples are illustrative only and not intended to be limiting.

SCGB3A2 and Lung Development

Lung tissue arises by budding from the ventral foregut at approximatelyembryonic day (E) 9.5 in mouse gestation (Kaufman & Bard (1999) TheAnatomical Basis of Mouse Development, Academic Press, London). Mouselung development is classified as four stages; pseudoglandular(E9.5-16.5), canalicular (E16.5-17.5), terminal saccular(E17.5-perinatal day (P) 5), and alveolar (P5-30) (Perl et al., (1999)Clin. Genet. 56, 14-27; Warburton et al., (2000) Mech. Dev. 92, 55-81).This classification is representative of the complexity of morphologicaland functional changes that occur during lung development.

Lung development is controlled temporally and spatially by varioustranscription factors and growth factors (Perl et al., (1999) Clin.Genet. 56, 14-27; Cardoso (2001) Annu. Rev. Physiol. 63, 471-94). Amongthem, TITF1, also called T/EBP, TTF1 or NKX2.1, is expressed in lung,thyroid and ventral forebrain during early embryogenesis (Lazzaro etal., (1991) Development 113, 1093-104; Kimura et al., (1996) Genes Dev.10, 60-9). Titf1-null mice die at birth due to profoundly hypoplasticlungs (Kimura et al., (1996) Genes Dev. 10, 60-9) in addition to otherdefects, including agenesis of the thyroid and pituitary, and severemalformation of hypothalamus. TITF1 expression appears in the ventralwall of the anterior foregut, an emergence of the lung primordium atE9.5 (Minoo et al., (1999) Dev. Biol. 209, 60-71). TITF1 expressioncontinues in the epithelial cells during lung development and throughoutadulthood, at which time, expression is confined to epithelial type IIcells (Yuan et al., (2000) Dev. Dyn. 217, 180-90). Titf1-null lungsexhibit only sac-like structures with rudimentary bronchi (Kimura etal., (1996) Genes Dev. 10, 60-9) and do not develop beyond the stage ofmain bronchi (Minoo et al., (1999) Dev. Biol. 209, 60-71; Yuan et al.,(2000) Dev. Dyn. 217, 180-90). The downstream targets for TITF1 thatcause this defect are not known.

SCGB3A2, which was originally named uteroglobin related protein 1(UGRP1), is a member of the uteroglobin/Clara cell secretory protein(UG/CCSP) gene superfamily of secretory proteins, officially namedsecretoglobin (SCGB) (Klug et al., (2000) Ann. N. Y Acad. Sci. 923,348-54). The prototypical protein of this gene superfamily, SCGB1A1 wasproposed as a novel cytokine (Mukherjee et al., (1999) Cell Mol Life Sci55, 771-87). SCGB3A2 was identified as a downstream target for TITF1 inlung using suppressive subtractive library screening of mRNAs isolatedfrom lungs of Titf1-null versus wild-type mice (Niimi et al., (2001)Mol. Endocrinol. 15, 2021-2036), and is predominantly expressed in theepithelial cells of trachea, bronchus, and bronchioles (Niimi et al.,(2001) Mol. Endocrinol. 15, 2021-2036).

SCGB3A2 expression is directly regulated by binding of TITF1 to siteslocated in the promoter of the SCGB3A2 gene (Niimi et al., (2001) Mol.Endocrinol. 15, 2021-2036). Recently, SCGB3A2 was demonstrated tosuppress allergen-induced lung inflammation using a mouse model forallergic airway inflammation (Chiba et al., (2006) Am. J. Respir. Crit.Care Med; 173(9):958-64). MARCO, a macrophage scavenger receptor withcollagenous structure that is expressed in lung alveolar macrophages andis involved in pulmonary inflammation, was identified as a receptor forSCGB3A2 (Bin et al., (2003) J. Immunol. 171, 924-30). Low SCGB3A2expression was detected in E12.5 mouse lungs, which markedly increasedby E16.5 as determined by RT-PCR (Niimi et al., (2001) Mol. Endocrinol.15, 2021-2036).

Prior to the present disclosure, the function of SCGB3A2 in lungdevelopment had not been determined. As disclosed herein, the arrest ofbranching and development found in Titf1-null lungs is due to thedeficiency of SCGB3A2 expression in these lungs. Indeed, SCGB3A2exhibits growth factor activity, promoting branching and/orproliferation of Titf1-null lungs ex vivo and in vivo. Rad23b, adownstream target of SCGB3A2 and a component of the DNA damage sensor,mediates this growth factor activity in response to SCGB3A2.

SCGB3A2 to Treat and/or Prevent Neonatal Respiratory Distress

Disclosed herein is the surprising discovery that the secretory proteinSCGB3A2 has both growth factor and anti-apoptotic activities, inaddition to its previously-known anti-inflammatory activities. In oneembodiment of the disclosure, the growth factor activity of SCGB3A2 isexploited for treating and/or inhibiting the development of neonatalrespiratory distress syndrome. The efficacy of this method wassurprising at least because the MARCO receptor previously was believedto mediate SCGB3A2's effects, and MARCO is expressed only at very lowlevels in fetal lung. (See, for instance, Elomaa et al., (1995) Cell80(4):603-609). Thus, prior to the present disclosure that SCGB3A2 alsohas growth factor activity that is mediated by a receptor other thanMARCO, SCGB3A2 would have been expected to have little if any effect onfetal lung tissue.

Neonatal respiratory distress (also called respiratory distress ofprematurity and respiratory distress syndrome (RDS)), results from alack of pulmonary surfactant, a substance that helps the lung's alveoliextract carbon dioxide from the blood and replace it with oxygen. Thesurfactant prevents the lung's alveoli from collapsing and helps keepthem properly inflated by reducing their surface tension. The absence ofsurfactant prevents the alveoli from functioning properly. RDS primarilyaffects premature infants, but also is more frequent in infants ofdiabetic mothers and in the second-born of premature twins.

A human delivery is considered premature when it occurs before 37 weeksof gestation. Although respiratory distress syndrome occurs even in afull-term infant, infants born at about 32 weeks or less gestation areat a greatly increased risk of developing respiratory distress syndrome.The risk of neonatal respiratory distress increases with increasingprematurity, and nearly all fetuses at 24 weeks' gestation or less willsuffer from the condition. Most fetuses at 24 weeks or less have not yetdeveloped alveoli, so approximately half of fetuses born at this stagewill die, even if treated with surfactant therapy and ventilation.Similar gestational dates can be extrapolated for other species, forexample, a mouse gestation generally is approximately 19 to 20 dayslong, and mice born at E17.5 generally exhibit respiratory distress.

Neonatal respiratory distress syndrome is ameliorated or even preventedentirely if mothers at risk for premature delivery receive SCGB3A2. Forexample, in some embodiments, SCGB3A2 is administered to the mother ifdelivery is expected within about two weeks, about one week, or evenless than a week, for instance within about three days, about two days,about one day, or even if delivery is expected within a matter of hours.Administration of SCGB3A2 to a gestational mother speeds the developmentof the fetal lungs and hastens their production of surfactant.

Preterm delivery can be predicted when a mother is exhibiting signs oflabor, for instance contractions, cervical dilation and/or thinning, orrupture of the amniotic membrane. In addition, the fetal fibronectintest can help predict whether a woman is likely to give birth within thenext 7-14 days. A negative result on the fetal fibronectin test means itis highly unlikely that birth will occur within that time frame. Apositive result indicates that premature birth is more likely.

If preterm labor is suspected or anticipated, lung maturity of the fetuscan be assessed with various tests carried out on the amniotic fluid.For very premature deliveries, or when there is not sufficient time tocarry out a test, SCGB3A2 is administered to the mother without firsttesting the fetal lung maturity. In pregnancies of greater than about 30weeks, or in a fetus of any gestational age wherein the lung maturity isuncertain, the fetal lung maturity may be tested by sampling the amountof surfactant in the amniotic fluid, obtained by inserting a needlethrough the mother's abdomen and uterus. Some maternal conditions, suchas diabetes, can impact fetal lung maturity such that surfactantproduction is insufficient, even at 40 weeks' gestation. The ‘maturitylevel’ of fetal lungs is expressed as the lecithin-sphingomyelin (or“L/S”) ratio. If this ratio is less than two, the fetal lungs may besurfactant deficient, and SCGB3A2 is administered. In some cases,SCGB3A2 is administered together with a glucocorticoid, which also aidsin surfactant production.

Administration to subjects in utero is normally accomplished bytransplacental administration or amniotic administration. Fortransplacental administration, the SCGB3A2 is administered to the motherparenterally, for instance by intravenous, intraperitoneal,intramuscular, intra-arterial, or subcutaneous injection or infusion, orby topical administration. In some instances, maternal administration isby inhalation. Generally, however, intravenous administration isappropriate.

An effective amount of SCGB3A2 is administered in a single dose, or inmultiple doses, for example weekly, daily, or multiple times daily,during a course of treatment. In one embodiment, a therapeuticallyeffective amount of a SCGB3A2 is administered as a single pulse dose, asa bolus dose, or as pulse doses administered over time. In pulse doses,a bolus administration of a SCGB3A2 is provided, followed by a timeperiod wherein no SCGB3A2 is administered to the subject, followed by asecond (and optionally subsequent) bolus administration. In specific,non-limiting examples, pulse doses of SCGB3A2 are administered duringthe course of a day, or during the course of a week or more, forinstance, from the onset of signs of premature labor until delivery.

In other embodiments, SCGB3A2 is used to treat neonatal respiratorydistress postnatally. SCGB3A2 is administered to a neonate parenterally(for example, intravenously, intramuscularly, intraperitoneally,intra-arterially, or subcutaneously), or directly to the lungs byinhalation or by endotracheal tube. By way of example, one method ofadministration to the lungs is by inhalation through the use of anebulizer or inhaler. For example, the SCGB3A2 is formulated in anaerosol or particulate and drawn into the lungs using a standardnebulizer well known to those skilled in the art. In addition toSCGB3A2, oxygen is given with a small amount of continuous positiveairway pressure (“CPAP”) in some embodiments, and intravenous fluids areadministered to stabilize the blood sugar, blood salts, and bloodpressure.

Alternatively, or if the infant's condition worsens, an endotrachealtube (breathing tube) is inserted into the trachea and intermittentbreaths are given by a mechanical device. SCGB3A2 is administered viathe endotracheal tube, and in some embodiments, an exogenous preparationof surfactant, either synthetic or extracted from animal lungs, is alsodelivered into the lungs in conjunction with the SCGB3A2. Response totreatment is measured by monitoring pulmonary function by methods knownto those of skill in the art. For example, various measurable parametersof lung function can be studied before, during, or after treatment.Pulmonary function can be monitored by testing any of several physicallymeasurable operations of a lung including, but not limited to,inspiratory flow rate, expiratory flow rate, lung volume, and oxygensaturation. An increase in one or more of these parameters indicatesefficacy of the SCGB3A2 treatment.

For both prenatal and postnatal administration of SCGB3A2, an effectivedose ranges from about 0.1 mg/kg to about 100 mg/kg of body weight. Inone specific, non-limiting example, an effective dose is from about 1mg/kg to about 20 mg/kg, or in even more particular examples, from about5 mg/kg to about 10 mg/kg of body weight.

SCGB3A2 to promote lung development

Also disclosed herein is the surprising discovery that the secretoryprotein SCGB3A2 promotes lung development. In one embodiment of thedisclosure, the growth factory activity of SCGB3A2 is exploited for thepromotion of lung development in a subject in need thereof. A subjectmay be in need of lung development, for instance, because they have orare at risk for developing neonatal respiratory distress. Alternatively,a non-neonatal or adult subject may be in need of lung developmentbecause they have suffered lung damage or because they have lost all orpart of a lung, or have lost all or part of a lung's capacity orfunction due to disease, accident or surgery.

Administration to the subject is normally accomplished by eitherparenteral administration, for instance by intravenous, intraperitoneal,intramuscular, intra-arterial, or subcutaneous injection or infusion, orby inhalation or by endotracheal tube. By way of example, one method ofadministration to the lungs of an individual is by inhalation throughthe use of a nebulizer or inhaler. For example, the SCGB3A2 isformulated in an aerosol or particulate and drawn into the lungs using astandard nebulizer well known to those skilled in the art.

In some embodiments, a nanoparticle-based drug delivery system is usedfor direct pulmonary delivery. (For instance, see Pandey et al., (2003)J. Antimicrobial Chemotherapy 52, 981-986). The small size of thenanoparticles is advantageous for delivery deep into the lungs (see forinstance, Jacobs & Muller (2002) Pharmaceutical Research 19, 189-94;Dailey et al., (2003) J. Controlled Release 86, 131-44). In someembodiments, poly(DL-lactide-co-glycolide) (PLG) polymers are chosen asthe drug carrier because of their biodegradability and biocompatibility(see, for instance, Anderson & Shive (1997) Advanced Drug DeliveryReviews 28, 5-24). In other embodiments, gelatin-based orpolybutylcyanoacrylate-based nanoparticles are used. Such nanoparticlesare delivered using a nebulizer, in some embodiments. Nanoparticle-baseddrug delivery systems are discussed at greater length below, in Example16.

An effective amount of SCGB3A2 is administered in a single dose, or inmultiple doses, for example daily, during a course of treatment. In oneembodiment, a therapeutically effective amount of a SCGB3A2 isadministered as a single pulse dose, as a bolus dose, or as pulse dosesadministered over time. Thus, in pulse doses, a bolus administration ofa SCGB3A2 is provided, followed by a time period wherein no SCGB3A2 isadministered to the subject, followed by a second bolus administration.In specific, non-limiting examples, pulse doses of SCGB3A2 areadministered during the course of a day, during the course of a week, orduring the course of a month.

Response to treatment is measured by monitoring pulmonary function bymethods known to those of skill in the art. For example, variousmeasurable parameters of lung function can be studied before, during, orafter treatment. Pulmonary function can be monitored by testing any ofseveral physically measurable operations of a lung including, but notlimited to, inspiratory flow rate, expiratory flow rate, lung volume,and oxygen saturation. An increase in one or more of these parametersindicates efficacy of the SCGB3A2 treatment.

The methods of measuring pulmonary function most commonly employed inclinical practice involve timed measurement of inspiratory andexpiratory maneuvers to measure specific parameters. For example, forcedvital capacity (FVC) measures the total volume in liters exhaled by apatient forcefully from a deep initial inspiration. This parameter, whenevaluated in conjunction with the forced expired volume in one second(FEV1), allows bronchoconstriction to be quantitatively evaluated. Anincrease in FVC or FEV1 reflects a decrease in bronchoconstriction, andindicates that SCGB3A2 therapy is effective.

A concern with forced vital capacity determination is that the forcedvital capacity maneuver (for instance, forced exhalation from maximuminspiration to maximum expiration) is largely technique-dependent. Inother words, a given subject may produce different FVC values during asequence of consecutive FVC maneuvers. The FEF 25-75 or forcedexpiratory flow determined over the midportion of a forced exhalationmaneuver tends to be less technique dependent than the FVC. Similarly,the FEV1 tends to be less technique-dependent than FVC. Thus, anincrease in the FEF 25-75 or FEV1 reflects a decrease inbronchoconstriction, and indicates that SCGB3A2 therapy is effective.

In addition to measuring volumes of exhaled air as indices of pulmonaryfunction, the flow in liters per minute measured over differing portionsof the expiratory cycle can be useful in determining the status of apatient's pulmonary function. In particular, the peak expiratory flow,taken as the highest airflow rate in liters per minute during a forcedmaximal exhalation, is well correlated with overall pulmonary functionin a patient with pulmonary fibrosis and other respiratory diseases.Thus, an increase in the peak expiratory flow following administrationof SCGB3A2 indicates that the therapy is effective.

An effective dose ranges from about 0.1 mg/kg to about 100 mg/kg of bodyweight. In one specific, non-limiting example, an effective dose is fromabout 1 mg/kg to about 20 mg/kg, or in even more particular examples,from about 5 mg/kg to about 10 mg/kg of body weight. In someembodiments, the SCGB3A2 is administered to the subject in combinationwith one or more other drugs, such as a bronchodilator, an expectorant,or a steroid.

SCGB3A2 to inhibit lung damage caused by anti-cancer agents

The effect of SCGB3A2 on bleomycin-induced DNA damage was examined usingprimary murine fetal lung mesenchymal cells in vitro and a mouse modelfor bleomycin-induced fibrosis in vivo. In both cases, SCGB3A2 repairedor suppressed bleomycin-induced DNA damage/fibrosis when given togetherwith or prior to bleomycin treatment, respectively. In addition, SCGB3A2repaired or suppressed bleomycin-induced fibrosis when administered upto two, three, or even four weeks after the commencement of bleomycintreatment. Thus, SCGB3A2 is useful for treating, reducing, andpreventing the lung damage caused by bleomycin and other cytotoxicantibiotic antineoplastic agents.

Thus, in yet another embodiment of the disclosure, the anti-apoptoticactivity of SCGB3A2 is exploited for the prevention or reduction orreversal (repair) of lung damage in a subject treated with ananti-cancer agent such as a cytotoxic antibiotic. Administration to sucha subject is normally accomplished by parenteral administration, forinstance by intravenous, intraperitoneal, intramuscular, intra-arterial,or subcutaneous injection or infusion, or by inhalation or byendotracheal tube. By way of example, one method of administration tothe lungs of an individual is by inhalation through the use of anebulizer or inhaler. For example, the SCGB3A2 is formulated in anaerosol or particulate and drawn into the lungs using a standardnebulizer well known to those skilled in the art.

In some embodiments, a nanoparticle-based drug delivery system is usedfor direct pulmonary delivery. Such nanoparticles are, in someembodiments, poly(DL-lactide-co-glycolide)-based, gelatin-based, orpolybutylacrylate-based nanoparticles. Nanoparticle delivery systems aredescribed in greater detail below in Example 16.

As described above, an effective amount of SCGB3A2 is administered in asingle dose, or in multiple doses, for example daily, during a course oftreatment, or as a single pulse dose, as a bolus dose, or as pulse dosesadministered over time.

Response to treatment is measured by monitoring pulmonary function bymethods known to those of skill in the art. For example, variousmeasurable parameters of lung function can be studied before, during, orafter treatment. Pulmonary function can be monitored by testing any ofseveral physically measurable operations of a lung including, but notlimited to, inspiratory flow rate, expiratory flow rate, lung volume,and oxygen saturation. An increase in one or more of these parametersindicates efficacy of the SCGB3A2 treatment. These methods and theirrelative advantages and disadvantages are described elsewhere in greaterdetail.

An effective dose ranges from about 0.1 mg/kg to about 100 mg/kg of bodyweight. In one specific, non-limiting example, an effective dose is fromabout 1 mg/kg to about 20 mg/kg, or in even more particular examples,from about 5 mg/kg to about 10 mg/kg of body weight, based on efficacy.In some embodiments, the SCGB3A2 is administered to the subject incombination with one or more other drugs, such as one or moreanti-cancer agents, bronchodilators, expectorants, or steroids.

In vitro use of SCGB3A2

In some embodiments, SCGB3A2 is used in vitro as a growth factor and/oranti-apoptotic agent, as well as in the study of lung development andthe mechanisms of drug-induced DNA damage. For example, recombinantSCGB3A2 is useful for the study of the mechanisms of lung branchingmorphogenesis, as well as SCGB3A2's anti-apoptotic function against DNAdamage caused by bleomycin.

Lung development is regulated by many transcription factors includingthe zinc finger transcription factors Gli1, 2 and 3, TITF1/NKX2.1,FOXA2/HNF-3β and GATA-6 (see, for instance, Hui et al. (1998) Dev. Biol.162: 402-413; Motoyama et al. (1998) Nat. Genet. 20: 54-57; Ang &Rossant, (1994) Cell 78: 561-574; Kimura et al. (1996) Genes Dev. 10:60-69; Perl & Whitsett (1999) Clin. Genet. 56: 14-27; Liu et al. (2002)Am. J. Physiol. Lung Cell. Mol. Physiol. 283: L468-475). Further,several growth factors and morphogens such as fibroblast growth factor(FGF) 10, sonic hedgehog (SHH) and bone morphologic protein (BMP) 4 havebeen shown to play a role in lung development (Bellusci et al. (1996)Development 122: 1693-170; Litingtung et al. (1998) Nat. Genet. 20:58-61; Perl & Whitsett (1999) Clin. Genet. 56: 14-27; Sekine et al.(1999) Nat. Genet. 21: 138-141; Cardoso (2001) Annu. Rev. Physiol. 63:471-494). However, the mechanisms how the activities of these factorsrelate to each other in promoting branching morphogenesis are not fullyunderstood.

Since SCGB3A2 also influences lung branching morphogenesis (as describedherein), understanding how SCGB3A2 affects expression of other factorsand participates branching morphogenesis provides a clearer view of themechanisms of lung branching morphogenesis. For instance, in embryoniclung organ cultures, addition of SCGB3A2 into the media increasedmesenchymal cells and the expression levels of FGFs, when examined byRT-PCR.

In order to elucidate the exact location of increased expression and theeffects of SCGB3A2 on the expression levels and patterns of other growthfactors such as SHH and BMP, for example, various amount of recombinantSCGB3A2 is added to the media of cultures of embryonic lung organ, lungprimary cells or cell lines. The levels and/or locations of expressionof other growth factors are examined and compared in the presence andabsence of SCGB3A2 by quantitative PCR, in situ hybridization, and/orimmunohistochemistry. Further, in some embodiments, recombinant SCGB3A2is bound to beads and placed onto a portion of lung tissue in organculture. This is particularly useful for elucidating and clarifying theeffects of SCGB3A2 on lung branching because the technique restricts theeffect of SCGB3A2 to a very small area, compared to the addition ofSCGB3A2 to culture media, which affects the entire organ culture.

The influence of SCGB3A2 on the expression levels and patterns of otherfactors, and how these factors participate in lung branchingmorphogenesis, is then demonstrated by morphological observation, wholemount hybridization, in situ hybridization, and/or immunohistochemistry.The use of growth factor-bound beads in the study of lung developmenthas been described for BMP4 and FGF10 (Lebeche et al. (1999) Mech. Dev.86: 125-136; Weaver et al. (2000) Development 127: 2695-2704).

Similarly, recombinant SCGB3A2 is used to elucidate the anti-apoptoticactivity of SCGB3A2 by its addition to culture media of embryonic lungorgan, lung primary cells or cell lines together, before or afteraddition of bleomycin. Tissues and/or cells are subjected to microarrayand/or protein array analysis, quantitative PCR, northern and/or Westernanalysis to determine which anti-apoptotic pathway interacts withbleomycin-induced DNA damage pathway.

In other embodiments, SCGB3A2 is used to treat lung cells or lung tissuein vitro, for instance for transplantation into immature, damaged, ordiseased lungs. Once transplanted, these cells and/or tissues are usedto rebuild or repair the lung damage in vivo. In one embodiment, thelung cell is a stem cell or progenitor cell. The subject of lungepithelial stem cells has been reviewed comprehensively (see, forinstance, Rawlins & Hogan (2006) Development 133, 2455-2465; Neuringer &Randall (2004) Respir. Res. 5,6; Neuringer & Randall (2006) MonaldiArch. Chest Dis. 65, 47-51). Both basal and columnar cells have beenshown to reconstitute a complete lung epithelium in an in vivo model ofdenuded tracheas (see, for instance, Liu et al. (1994) Am. J. Physiol.266, L296-L307; Avril-Delplanque et al. (2005) Stem Cells 23, 992-1001),and in some species, basal tracheal cells have the ability to form largedifferentiated epithelial colonies (see, for instance, Hong et al.(2004) Am. J. Physiol. 164, L631-L649). Additionally, Clara cells may beconsidered stem or progenitor cells because they proliferate to restorethe bronchiolar epithelium following injury by oxidant gases (see, forinstance, Evans et al. (1986) Am. J. Pathol. 123, 126-133). In general,the lung cells are isolated from a donor airway epithelium, and aredissociated and seeded onto membranes and cultured at the air-liquidinterface (see, for instance, Schoch et al. (2004) Am. J. Physiol. LungCell Mol. Physiol. 286, L631-L642) in the presence of about 10 ng-10mg/ml SCGB3A2.

In other embodiments, lung tissue explants are grown in the presence ofabout 10 ng-10 mg/ml SCGB3A2 in order to prepare the lung tissue fortransplantation into an area of diseased or damaged lung tissue.Briefly, in one embodiment, lung tissue is isolated from a donor andcultured in DMEM/F12 containing 10% FBS on a 0.4 μm pore membrane (forinstance, Millipore Corporation, Billerica, Mass.), which is placed onthe top of steel wire mesh in an organ culture dish (for instance,Becton Dickinson, Franklin Lake, N.J.). Lung explants are then incubatedwith SCGB3A2 and cultured for two to four days or more at 37° C. in a 5%humidified 95% CO₂ air incubator. Every day or every two days, media andthe additives (SCGB3A2) are replaced. Once the lung explants havereached the desired size and/or maturity, they are transplanted into anarea of diseased or damaged lung.

In other embodiments, lung cells are grown on poly-DL-lactic acidscaffolds in order to engineer lung tissue for transplant (see, forinstance, Lin et al. (2006) J. Biomaterials Applications 21, 109-118).Poly-DL-lactic acid (PDLLA) is a well-known super-high molecular-weightacid that has good biocompatibility and degrades following in vivoimplantation (see, for instance, Lee & Gardella (2002) Analytical andBioanalytical Chem., 373(7): 526-537). It has been previously shown thatPDLLA, alone or as a composite, supports the growth of osteoblasts,chondrocytes, and lung carcinoma cells (see, for instance, Roether etal. (2002) Biomaterials, 23(18): 387-392; Blaker et al., (2003) J.Biomed. Mater. Res., 67A(4): 1401-1406; Verrier et al. (2004)Biomaterials, 25(15): 3013-3017; Maquet et al., (2004) Biomaterials,25(18): 4185-4189). These features, plus the intrinsic adequate elasticproperties and flexibility of PDLLA, make this biodegradable polymersuitable for lung tissue engineering (see, for instance, Lin et al.(2006) J. Biomaterials Applications 21, 109-118). Methods of culturinglung cells on PDDLA membranes are discussed at greater length in Example17, below.

Pharmaceutical Compositions that Include SCGB3A2

SCGB3A2 may be formulated in a variety of ways, depending in part on thetype of disease or condition to be treated. Pharmaceutical compositionsare provided for both inhalational use and for systemic use, by way ofexample. The disclosure includes within its scope pharmaceuticalcompositions comprising SCGB3A2 formulated (or an equivalent thereof)for use in human or veterinary medicine. While SCGB3A2 will typically beused to treat human subjects, it also may be used to treat similar oridentical diseases in other vertebrates, such other primates, sheep,chimpanzees, mice, dogs, cats, horses, and cows.

Pharmaceutical compositions that include SCGB3A2 as an activeingredient, or that include both SCGB3A2 and an additional respiratoryagent as active ingredients, may be formulated with an appropriate solidor liquid carrier, depending upon the particular mode of administrationchosen. Additional active ingredients include, for example,anti-infective agents, anti-inflammatory agents, bronchodilators,enzymes, expectorants, steroids, and anti-cancer agents. A suitableadministration format may best be determined by a medical practitionerfor each subject individually. Various pharmaceutically acceptablecarriers and their formulation are described in standard formulationtreatises, e.g., Remington's Pharmaceutical Sciences by E. W. Martin.See also Wang, Y. J. and Hanson, M. A., Journal of Parenteral Scienceand Technology, Technical Report No. 10, Supp. 42: 2S, 1988.

The dosage form of the pharmaceutical composition will be determined bythe mode of administration chosen. For instance, in addition toinjectable fluids, inhalational formulations are employed in someembodiments. Inhalational preparations include aerosols, particulates,and the like. In general, the goal for particle size for inhalation isabout 1 μm or less in order that the pharmaceutical reach the alveolarregion of the lung for absorption. Actual methods of preparing suchdosage forms are known, or will be apparent, to those of ordinary skillin the art.

The compositions or pharmaceutical compositions can be administered byany route, including parenteral administration, for example,subcutaneous, intravenous, intra-arterial, intraperitoneal,intramuscular, intraperitoneal, or intramuscular injection or infusion,or by pulmonary inhalation. When SCGB3A2 is provided as parenteralcompositions, for instance for injection or infusion, it is generallysuspended in an aqueous carrier, for example, in an isotonic buffersolution at a pH of about 3.0 to about 8.0, preferably at a pH of about3.5 to about 7.4, 3.5 to 6.0, or 3.5 to about 5.0. Useful buffersinclude sodium citrate-citric acid and sodium phosphate-phosphoric acid,and sodium acetate/acetic acid buffers. A form of repository or “depot”slow release preparation may be used so that therapeutically effectiveamounts of the preparation are delivered into the bloodstream over manyhours or days following transdermal injection or delivery.

For administration by inhalation, the compounds for use according to thepresent disclosure are conveniently delivered in the form of an aerosolspray presentation from pressurized packs or a nebulizer, with the useof a suitable propellant, for instance, dichlorodifluoromethane,trichlorofluoromethane, dichlorotetrafluoroethane, carbon dioxide orother suitable gas. In the case of a pressurized aerosol, the dosageunit can be determined by providing a valve to deliver a metered amount.Capsules and cartridges for use in an inhaler or insufflator can beformulated containing a powder mix of the compound and a suitable powderbase such as lactose or starch.

In some embodiments, a nanoparticle-based drug delivery system is usedfor direct pulmonary delivery. For instance,poly(DL-lactide-co-glycolide) (PLG) polymers are chosen as the drugcarrier because of their biodegradability and biocompatibility (see, forinstance, Anderson & Shive (1997) Advanced Drug Delivery Reviews 28,5-24). In some examples, PLG nanoparticles are prepared using a multipleemulsion technique described by Lamprecht et al. ((1999) InternationalJournal of Pharmaceutics 184, 97-105). The PLG nanoparticles encapsulatethe SCGB3A2, and the nanoparticles are administered using a nebulizer.

In other embodiments, the nanoparticles are made from mannitol, lactose,gelatin, or polybutylcyanoacrylate (see, for instance, Sham et al.(2004) International Journal of Pharmaceutics 269, 457-467). To prepareinhalable nanoparticle powders, spray-drying is a commonly practicedmethod (see, for instance, Bosquillon et al. (2001) J. Control. Release70, 329-339; Mackin et al. (1997) Pharm. Sci. 3, 583-586; Vanbever etal. (1999) Pharm. Res. 16, 1735-1742). Exemplary methods for thepreparation of gelatin nanoparticles can be found in Sham et al. (2004)Int. J. Pharma. 269, 457-467 and Coester et al. (2000) J. Microencapsul.17, 187-193, and are described below in Example 16.

Without further elaboration, it is believed that one skilled in the artcan, using this description, utilize the present discoveries to theirfullest extent. The following examples are illustrative only, and notlimiting of the disclosure in any way whatsoever.

EXAMPLE 1 Materials and Methods used for SCGB3A2 Protein and AnimalStudies

This Example illustrates specific methods used to carry out theexperiments described in Examples 2-14, below.

SCGB3A2 Protein

Two kinds of recombinant mouse SCGB3A2 protein were used that wereobtained using a bacterial expression plasmid pET32a-Trx(thioredoxin)-His (histidine)-SCGB3A2 (pET32a from Novagen, San Diego,Calif.) and pDest-544-His6-NusA (N utilization substance protein A)-TEV(Tobacco Etch Virus)-SCGB3A2. In these expression plasmids, a mouseSCGB3A2 cDNA sequence excluding the region encoding the signal peptide(from +155 to +443) was used. Trx-His-tagged recombinant SCGB3A2 proteinwas produced in BL21 by inducing with isopropyl-β-D-thiogalactopyranosid(IPTG) and was purified by a Ni-NTA Spin Columns (Qiagen, Valencia,Calif.) or TALON Superflow Metal Affinity Resin (BD Biosciences, PaloAlto, Calif.). His6-NusA-TEV-SCGB3A2 protein was produced in Rosetta(DE3) cells (Novagen), which was then subjected to extensivepurification steps including TEV protease digestion. TheTrx-His-recombinant SCGB32 was used for all ex vivo and cell culturestudies whereas highly purified tag-free, endotoxin-free (endotoxinlevel 0.2 EU/mg) SCGB3A2 was used for all animal studies. Mice receivedintravenous injection of up to total of 200 μg of SCGB3A2 via the tailvein (less than 5 EU/kg of the maximum endotoxin allowed). All animalstudies were carried out in accordance with the Using Animals inIntramural Research Guidelines (NIH Animal Research Advisory Committee,NIH, Bethesda, Md.) after approval by the NCI Animal Care and UseCommittee.

Organ Culture

Fetal lungs were isolated from pregnant female mice at E11.5-12.0 orE16.5. Lungs were cultured in DMEM/F12 containing 10% FBS on a 0.4 μmpore membrane (Millipore Corporation, Billerica, Mass.), which wasplaced on the top of steel wire mesh in an organ culture dish (BectonDickinson, Franklin Lake, N.J.). Lungs were incubated with variousadditives as indicated, or transfected with Rad23b or negative siRNAprobe using HiPerFect Transfection Reagent (Qiagen, Valencia, Calif.),and cultured for two to four days at 37° C. in a 5% humidified 95% CO₂air incubator. Every two days, media and the additives were changed.Experiments were performed using more than three lungs per condition pera given occasion, and were repeated 3-10 times.

Rad23b siRNA Probes:

Rad23b siRNA probes1 and 2 have the following sequences: Probe 1, 5′-GUAGCA GGU CAG AAG UUA A-3′ (sense; SEQ ID NO: 1) and 5′-UUA ACU UCU GACCUG CUA C-3′ (antisense; SEQ ID NO: 2); Probe 2,5′-GCU UCA CAU UAG UAUGAG A-3′ (sense; SEQ ID NO: 3) and 5′-UCU CAU ACU AAU GUG AAG C-3′(antisense; SEQ ID NO: 4); negative siRNA, 5′-UUC UCC GAA CGU GUC ACGU-3′(sense; SEQ ID NO: 5) and 5′-ACG UGA CAC GUU CGG AGA A-3′(antisense; SEQ ID NO: 6).

Histological Analysis

Lungs were fixed in 4% paraformaldehyde (PFA) overnight at 4° C. andembedded in paraffin or O.C.T. Compound (SAKURA, Torrance, Calif.).Immunohistochemistry and in situ hybridization were carried out aspreviously described (Chiba et al., (2006) Am. J. Respir. Crit. Care MedMay 1; 173(9):958-64; Srisodsai et al., (2004) J. Biol. Chem. 279,54358-54368) using 4 μm sections. Antibodies used forimmunocytochemistry and immunohistochemistry are as follows:anti-histidine (Penta-His antibody, QIAGEN, Valencia, Calif.),anti-thioredoxin (Invitrogen, Carlsbad, Calif.), anti-MARCO (Serotec,Raleigh, N.C.), anti-TITF1 (DAKO, Carpinteria, Calif.),anti-phospho-histone H3 (Upstate, Lake Placid, N.Y.), and anti-Ki-67(GeneTex, San Antonio, Tex.). Anti-SCGB3A2 antibody was as previouslydescribed (Niimi et al., (2001) Mol. Endocrinol. 15, 2021-2036). Cellsfor positive immunostaining were counted using five areas each (×400magnification) randomly chosen, from three sections of in vivo tissuesand five sections of ex vivo tissues. The number obtained was expressedas a percentage of the total cells.

Breathing Scores

The E17.5 pups from PBS, 100 μg SCGB3A2, or 200 μg SCGB3A2-treatedgroups were subjected to measurement of breathing scores. The pupsremoved from the mothers were placed on moistened filter paper at 37° C.Each pup's breathing motion was observed for two minutes by twoindependent investigators. Scoring assignment was carried out accordingto the criteria described by Ozdemir et al. (Pediatr. Res. 53, 98-103(2003)) as follows: respiratory pattern 0=no breathing; 1=gasping;2=gasping/labored breathing; 3=labored breathing; 4=laboredbreathing/unlabored breathing; 5=unlabored breathing. Gasping wascharacterized as isolated breathing with the mouth opened and the neckextended. Labored breathing involved abdominal and extremity movement,whereas unlabored breathing required chest motion only (Ozdemir et al.(2003) Pediatr. Res. 53, 98-103).

RT-PCR and Quantitative PCR Analysis

Quantitative RT-PCR was performed by SYBR Green master mixture andanalyzed with ABI Prism 7900 Sequence Detection System (AppliedBiosystems, Foster City, Calif.). The following primers were used forboth RT-PCR and quantitative PCR: Rad23b, (forward) 5′-GGA GGA GAC GGTAAA GGC ATT G-3′ (SEQ ID NO: 7), (reverse) 5′-TGG GGA AGA ACT GAC TGTAGT GGG-3′ (SEQ ID NO: 8); FGF2, (forward) 5′-ATG AAG GAA GAT GGA CGGCTG-3′ (SEQ ID NO: 9), (reverse) S—CCA GTT CGT TTC AGT GCC ACA-3′ (SEQID NO: 10); FGF7, (forward) 5′-AAG ACT GTT CTG TCG CAC CCA-3′ (SEQ IDNO: 11), (reverse) 5′-GCC ACA ATT CCA ACT GCC A-3′ (SEQ ID NO: 12);FGF9, (forward) 5′-CTA CCT CGG CAT GAA CGA GAA-3′ (SEQ ID NO: 13),(reverse) 5′-ATC TCC TTC CGG TGT CCA CAT-3′ (SEQ ID NO: 14); FGF10,(forward) 5′-TTT GGT GTC TTC GTT CCC TGT-3′ (SEQ ID NO: 15), (reverse)5′-AGG TGA TTG TAG CTC CGC ACA-3′ (SEQ ID NO: 16); 18S, (forward) 5′-CGGCTA CCA CAT CCA AGG AA-3′ (SEQ IS NO: 17), (reverse)5′-ATTGGAGCTGGAATTACCGC-3′ (SEQ ID NO: 18); SP-A, (forward) 5′-TAA GAAGCC AGA GAA CCA GGT AGG-3′ (SEQ ID NO: 23), (reverse) 5′-CTC AGT GAT GTAAAG TGG ACG AAG G-3′ (SEQ ID NO: 24); SP-D, (forward) 5′-TTT GAG GAT GCCCAG GAG ATG TGC-3′ (SEQ ID NO: 25), (reverse) 5′-AGG AAA GCA GCC TTG TTGTGG-3′ (SEQ ID NO: 26); AQP1, (forward) 5′-GCT CAC CCG CAA CTT CTC AAAC-3′ (SEQ ID NO: 27), (reverse) 5′-TCA GCA TCC AGG TCA TAC TCC TCC-3′(SEQ ID NO: 28); OB-R, (forward) 5′-AGG AAT CGT TCT GCA AAT CCA-3′ (SEQID NO: 29), (reverse) 5′-TAT GCC AGG TTA AGT GCA GCT ATC-3′ (SEQ ID NO:30).

Unless otherwise specifically noted in particular Examples below, theconditions used for RT-PCR were 94° C., 5 minutes, followed by 94° C.for 15 seconds, 60° C. or 62° C. (for Rad23b) for 15 seconds, 72° C. for30 seconds, 72° C. for five minutes for 25-28 cycles depending on gene,and for quantitative PCR, 50° C. for 2 minutes, 95° C. for 10 minutes,followed by 95° C. for 15 seconds, 60 or 62° C. (for Rad23b) for 40seconds for 45 cycles. The standard curve method was used and all datawere normalized to 18S rRNA.

Construction of pDest-544-His6-NusA-TEV-SCGB3A2

pDonr223 is a Gateway Donor vector modified from pDonr201 (Invitrogen).In pDonr223, the kanamycin resistance gene is replaced with a geneencoding spectinomycin resistance, and several sequencing primer siteshave been added to aid in sequence verification of Entry clones.pDest-544 is a Gateway Destination vector generated by modification ofpET-43b (Novagen, Inc), which contains a T7 promoter and anamino-terminal His6-NusA fusion tag. The following oligonucleotides(Operon, Inc) were used in this study: L2575, 5′-GGC GAA AAC CTG TAC TTCCAA GGC ATG CTT CTC ATC AAC CGT CTC CCT GTT GTT GAC-3′ (SEQ ID NO: 19);L2576, 5′-GGG GAC AAC TTT GTA CAA GAA AGT TGG CTA TAC CAG GTG TGA AAGAGC CTC C-3′ (SEQ ID NO: 20); L907, 5′-GGG GAC AAC TTT GTA CAA AAA AGTTGG CGA AAA CCT GTA CTT CCA AGG C-3′(SEQ ID NO: 21).

A SCGB3A2 cDNA fragment used to constructpDest-544-His6-NusA-TEV-SCGB3A2 was first amplified using 95° C. for twominutes, followed by five cycles of 95° C. for 30 seconds, 55° C. for 45seconds, and 72° C. for 60 seconds with 200 nM each of primers L2575(SEQ ID NO: 19) and L2576 (SEQ ID NO: 20), and the original SCGB3A2 cDNAclone (Niimi et al. (2001) Mol. Endocrinol. 15, 2021-2036; clone #12).Following this, 200 nM of adapter primer L907 (SEQ ID NO: 21) was added,and 15 more cycles of amplification were carried out using the samecycling parameters with Platinum Taq HiFidelity (Invitrogen). Allcycling was done on an Applied Biosystems 9700 cycler. After cycling, a72° C., five minute incubation was carried out to extend PCR products,followed by cooling to 4° C. The final PCR product contains the matureform of the SCGB3A2 gene (starting at amino acid 22 of the full-lengthprotein sequence) flanked on the 5′ side with a Gateway attB1 site andTobacco Etch Virus (TEV) protease cleavage site. The 3′ side contains aGateway attB2 recombination site. The PCR products were cleaned with theQiaQuick PCR purification kit (Qiagen), and recombined into pDonr223 byGateway BP recombination (Invitrogen) using the manufacturer'sprotocols. The subsequent Entry clone was sequence verified, andsubcloned by Gateway LR recombination into pDest-544. The finalexpression clone (3152-X1-544) encodes a protein of the formHis6-NusA-TEV-SCGB3A2 mature. The linker between the fusion tag and theSCGB3A2 gene consists of the amino acid sequence ENLYFQG (SEQ ID NO:22), which is cleaved by Tev protease between the Q and G residues toleave only a single glycine at the amino terminus of the mature SCGB3A2gene.

Expression of His6-NusA-TEV-SCGB3A2

The expression clone was transformed into E. coli Rosetta (DE3) cells(Novagen).

Five ml of an overnight culture grown at 37° C. in CircleGrow medium(Qbiogene) containing 100 μg/ml ampicillin and 15 μg/mlchloramphenicolwere used to innoculate a four-liter baffled shake flask containing oneliter of LB medium with the same antibiotics. After incubation at 37° C.at 200 rpm for seven hours, 450 ml of this seed culture (OD₆₀₀=2.10)were added to a 20 liter New Brunswick Scientific BioFlo IV fermentercontaining 15 liters of modified Studier ZYM5052 medium, whose finalcomposition was 1% N—Z-amine AS, 0.5% yeast extract, 25 mM Na₂HPO₄, 25mM KH₂PO₄, 50 mM NH₄C1, 5 mM Na₂SO₄, 2 mM MgSO₄, 1 mM trisodium citrate,0.2× trace metals, 2% glycerol, 0.05% glucose, 0.2% α-lactose, 25 mMsuccinic acid, 100 μg/mL ampicillin, and 15 μg/mL chloramphenicol. Thismedium corresponds to ZYP5052 with the following adjustments: salts wereat half concentration, glycerol was increased from 0.5 to 2% to increasecell yield, and succinic acid was added to stabilize pH. Cells weregrown at 37° C. with monitoring (but without control) of pH but withoutsupplemental feeding, and dissolved oxygen was maintained at 40%. Afterfive hours (A₆₀₀=5.19), the temperature was reduced to 20° C. and growthcontinued until harvest at 18 hours (stationary phase was reached at 16hours, final A₆₀₀=24.0, final pH 5.42). Cells (3.6×10⁵ A₆₀₀ units, 626grams wet weight) were harvested and stored at −80° until use.Non-Denaturing Purification by Immobilized Metal Ion AffinityChromatography (IMAC)

E. coli cell pastes were resuspended with four volumes of extractionbuffer (for a final concentration of 20 mM HEPES, pH 7.3, 100 mM NaCl, 5mM MgCl₂, 5% glycerol, 45 mM imidazole, and Complete protease inhibitoras per the manufacturer's instructions, Roche) per gram wet weight,digested with lysozyme (0.5 mg/ml, Sigma) for 30 minutes on ice andtreated with 10 U Benzonase (Novagen)/ml for an additional 20 minutes.The sample was sonicated to lyse the cells using a Branson DigitalSonifier 450 (100% power, 33% duty cycle, for 3×20 sec with a 1 cm tip)and lysis was verified by microscopic examination. The lysate wasadjusted to 500 mM NaCl, clarified by centrifugation at 111,000×g for 30minutes, filtered (0.45 PES membrane) and applied to His Trap columns(GE Healthcare) equilibrated with extraction buffer in 500 mM NaCl and45 mM imidazole (binding buffer). The columns were washed with bindingbuffer to baseline, proteins eluted over 20 column volume (CV) gradientsto 400 mM imidazole.

TEV Protease Digestion and Subsequent Purification

The pool created from the IMAC was dialyzed against binding bufferwithout additional imidazole and treated with TEV protease (3% v/v witha 5 mg/ml lab stock) at room temperature for four hours and then shiftedto 16° C. overnight and analyzed by SDS-PAGE. An additional IMAC stepsimilar to the initial IMAC was used to purify the target protein awayfrom the contaminants of the protease digest.

Ion-Exchange Chromatography

A protein sample was dialyzed against 20 mM HEPES, pH 7.3, 100 mM NaCland 5% glycerol and applied to Q Sepharose resin in pre-poured columns(GE Healthcare) using a chromatography workstation (AKTA-Purifier, GEHealthcare) made endotoxin free by cleaning with 0.01% Triton X-114(Sigma). Proteins were eluted with a 0.1 to 1M NaCl gradient over 20 CV.At each purification step, fractions were analyzed by SDS-PAGE, andtested for endotoxin levels. The final endotoxin levels were determinedby Cambrex Bio Science (Walkersville, Md.).

Samples were then dialyzed twice for at least four hours at 4° C.against at least 20 sample volumes of final buffer using 3.5K MWCOSnakeskin (Pierce) dialysis membrane. When necessary, samples wereconcentrated using 5K MWCO Amicon Ultra filtration devices (Millipore).

5-Bromo-2′-deoxyuridine Incorporation

5-Bromo-2′-deoxyuridine (BrdU) was directly added to the culture mediumof fetal lung primary cells to achieve a final concentration of 10 μM,and cells were incubated for one hour at 37 C.°. Cells were thentrypsinized and fixed in 75% ethanol for 24 hours. Fixed cells weretreated with 1 ml of 2N HCl containing 0.5% triton X-100 at roomtemperature for 30 minutes and neutralized with 1 ml of 0.1 MNa₂B₄O₇.10H₂O, PH 8.5. The cells were centrifuged and suspended in 1 mlof PBS containing 0.5% Tween 20 and 1% BSA, and incubated for 30 minutesat room temperature with 20 μl of Anti-BrdU FITC (Becton Dickinson, SanJose, Calif.), followed by centrifugation and resuspension in 1 ml ofPBS containing 5 μg/ml pf propidium iodide (BD Biosciences Pharmingen,San Diego, Calif.). Measurement of red (DNA content) and green (BrdU)fluorescence was determined by flow cytometry.

Flow Cytometric Analysis

Cells were analyzed using a single laser FACS Calibur cytometer (BectonDickinson, San Jose, Calif.) with excitation at 488 nm. The data werecollected and analyzed employing CellQuest Software. The red fluorescentsignals (DNA content) were analyzed on a linear scale and the greensignals (BrdU) were analyzed on a logarithmic scale. The data arepresented as a percentage of the total population exhibiting thefluorescence signal of interest. For each sample, 10,000 cells wereanalyzed.

DNA Microarray

Titf1-null lungs at E16.5 were cultured in an organ culture system withor without 250 ng/ml SCGB3A2 protein for four days. Total RNAs fromthese lungs were isolated by TRIzol (Invitrogen, Carlsbad, Calif.) andthen incubated with DNase I (Ambion, Austin, Tex.) for 20 minutes at 37°C. RNAs were amplified using MessageAmp aRNA Kit (Ambion, Austin, Tex.),and amplified RNAs were reverse-transcribed to label with Cy3 and Cy5(GE Healthcare Life Sciences, Piscataway, N.J.) using FairPlayMicroarray Labeling Kit (Stratagene, La Jolla, Calif.). Ten mouse arrays(42.2 K) obtained from the NCI Microarray Facility were used for thisexperiment. Experiments and analysis were performed according to themanufacturer's instructions and the protocol of the Center for CancerResearch, NCI.

EXAMPLE 2 Effect of SCGB3A2 on Branching Morphogenesis in Fetal Lung

This Example demonstrates that SCGB3A2 increases branching morphogenesisin fetal lung explant cultures.

SCGB3A2 expression was detected by immunohistochemistry, albeit at lowlevels in the epithelial cells of E11.5 and 13.5 normal fetal lungs(FIG. 1A), where TITF1 that regulates SCGB3A2 is expressed (FIG. 1B). Inthe E 13.5 lungs, the expression was particularly evident in the growingtips of the bronchi. To determine a possible role for SCGB3A2 in theearly embryonic stages of lung development, lungs from E11.5-12.0embryos were subjected to ex vivo organ culture with and withoutrecombinant SCGB3A2 protein. The recombinant SCGB3A2 containedthioredoxin and histidine tags as a fusion protein at the N-terminus ofSCGB3A2. This fusion recombinant protein was immunoreactive withanti-SCGB3A2 antibody, and was used for all ex vivo and cell culturestudies. For in vivo studies, SCGB3A2 used was highly purified,tag-free, and endotoxin-free.

After four days of culture, normal fetal lung harvested at E11.5 (FIG.1C) exhibited some degree of branching morphogenesis (FIG. 1D).Branching was facilitated by the addition of 50 (FIG. 1E) or 250 ng/ml(FIG. 1F) SCGB3A2, which induced 1-2 and 2-3 additional branchings,respectively in comparison to control. Addition of 2% SCGB3A2-specificantiserum in the culture media together with SCGB3A2 protein inhibitedthe effect of SCGB3A2 (FIGS. 1G and 1H). Lung treated with pre-immuneserum proceeded with a similar degree of branching to control,indicating that serum itself does not influence branching (FIG. 1I).Further, anti-SCGB3A2 antiserum delayed branching, likely due to itsabsorption of endogenously produced SCGB3A2 that was secreted into theculture media (FIG. 1J).

EXAMPLE 3 SCGB3A2 Promotes Branching Morphogenesis in Titf1-Null Lung

This Example demonstrates that SCGB3A2 promotes branching in lungs fromTitf1-null mice and produces a recovery of the epithelialcharacteristics of Titf1-null mouse trachea and lung similar to thosefound in wild-type mice.

Titf1-null lungs exhibit vacuolar lobes consisting of rudimentarybronchi with lean mesenchymal layers (FIG. 2A). Based on the hypothesisthat the arrest of branching and development in Titf1-null lungs is atleast partly due to a deficiency of SCGB3A2, the effect of SCGB3A2 onTitf1-null lung development was investigated ex vivo and in vivo. Afterculturing for four days ex vivo, E16.5 Titf1-null lung displayeddistended morphology (FIG. 2C), consisting of one layer of epithelia andone layer of mesenchyme (FIG. 2E). Upon the addition of SCGB3A2,however, a drastic morphological change took place. Many pleatedstructures were observed in SCGB3A2-stimulated Titf1-null lungs (FIG.2B), consisting of pleated and/or dentate epithelia and duct-likestructures with increased layers of mesenchyme (FIGS. 2D and 2F). Thesedata indicate that SCGB3A2 induced branching in Titf1-null lung ex vivo.

The epithelia of trachea and lung in Titf1-null mice were comprised ofone to two layers of columnar epithelial cells covered with flattenedepithelial and few ciliated cells (FIGS. 2G and 2I). When SCGB3A2 wasadministered to Titf1-heterozygous females carrying null fetuses,stratified columnar cells with cilia appeared throughout the epitheliaof the trachea and lung of Titf1-null fetuses (FIGS. 2H and 2J). Thesedata indicate that SCGB3A2 promotes fetal lung development.

EXAMPLE 4 SCGB3A2 Induces Proliferation in Titf1-Null Trachea and Lung

This Example demonstrates that the phenotypes produced bySCGB3A2-treatment of trachea and lungs from Titf1-null mice are causedby increased cell proliferation.

To examine whether increased proliferation is responsible for thephenotypes observed in the Titf1-null lungs and trachea by SCGB3A2treatment, the expression of phosphorylated histone H3 as a mitosismarker and Ki-67 as a proliferation marker, was examined byimmunohistochemistry using Titf1-null mice with and without SCGB3A2. Inex vivo cultured Titf1-null lungs as well as lung and trachea ofTitf1-null mice, both phosphorylated histone H3 and Ki-67 were veryweakly expressed without SCGB3A2 in both epithelial and mesenchymalcells (see, e.g., FIG. 7). Upon administration of SCGB3A2, theexpression of phosphorylated histone H3 and Ki-67 were markedlyenhanced, in most cases with statistically significant differences asdetermined by positive cell numbers (FIGS. 3A-C). In particular, Ki-67expression was markedly increased by SCGB3A2 treatment in the tracheaand lung of Titf1-null mice (FIG. 3C).

Further, the effect of SCGB3A2 on cell proliferation was accuratelydetermined by BrdU incorporation into primary mesenchymal cells preparedfrom wild-type mouse fetal lung. A statistically significant increasewas obtained, indicating that SCGB3A2 enhanced cell proliferation (FIG.3D). Cells with sub-G1 content of DNA, consistent with cell death, werenot apparent in cells exposed to various concentrations of SCGB3A2 formore than 48 hrs. These results demonstrate that SCGB3A2 enhanced lungmesenchymal cell proliferation.

Since SCGB3A2 treatment increased mesenchymal cells in fetal lungs, itwas interesting to determine the expression levels of several FGFs, thegrowth factor mainly expressed in mesenchymes and known to be involvedin lung development. Among FGFs analyzed by RT-PCR using RNAs isolatedfrom ex vivo cultured Titf1-null fetal lungs, FGF7 expression wasdramatically increased, while FGF2 and FGF9 were minimally increasedupon SCGB3A2 treatment (FIG. 3E). Taken together, these resultsdemonstrate that SCGB3A2 induced cell proliferation in Titf1-nulltrachea and lung.

EXAMPLE 5 Localization of a SCGB3A2-Specific Receptor in Fetal Lung

This Example demonstrates that the known receptor for SCGB3A2, MARCO, isnot responsible for the effects of SCGB3A2 on fetal lungs, and that anindependent SCGB3A2-specific receptor likely exists in fetal lungs,especially in mesenchyme.

MARCO is the known receptor for SCGB3A2 (Budinger et al., (2006) Proc.Natl. Acad. Sci. U.S.A. 103:4604-4609). In order to determine whether areceptor for SCGB3A2 other than MARCO is present in fetal lung, andwhere it might be localized, wild-type fetal lung primary epithelial andmesenchymal cells were treated with histidine and thioredoxintag-containing SCGB3A2, and were then subjected to immunocytochemistryusing anti-histidine and anti-thioredoxin antibodies (FIG. 4).Immunocytochemistry results revealed that no MARCO immunoreactivity wasdetected in either epithelial or mesenchymal cells of fetal lung primaryculture (FIGS. 4A-D). In contrast, strong signals were detected on thesurface of mesenchymal cell membranes, after addition of tagged SCGB3A2,by specific antibodies for histidine and thioredoxin (FIGS. 4H and 4L).Epithelial cells demonstrated no immunoreactivity regardless of SCGB3A2treatment (FIGS. 4E, 4F, 4I, and 4J). These data indicate that aSCGB3A2-specific receptor, distinct from MARCO, exists in themesenchymal cells of fetal lung.

EXAMPLE 6 Identification of a SCGB3A2 Target Gene

This Example illustrates the fact that Rad23b is a downstream target ofSCGB3A2 that is involved in SCGB3A2's proliferative effects.

In order to identify genes that are controlled by SCGB3A2 and areresponsible for branching, mouse DNA microarray analysis was carried outusing Titf1-null lungs with and without SCGB3A2 treatment. Over eightySCGB3A2-up-regulated genes were selected for further examination for thelevel and localization of expression by quantitative PCR and in situhybridization. The focus was on genes localized to the mesenchyme, inwhich a SCGB3A2-specific receptor is likely to be present.

Expression of one gene, Rad23b, was always up-regulated by SCGB3A2 inall microarray analyses carried out (n=5), and the representative scorewas 2.4892±0.242048. Rad23b expression was increased 4.73-fold in the exvivo Titf1-null lungs after SCGB3A2 stimulation as determined byquantitative PCR.

Rad23b is one of the two Mus musculus homologs of the Saccharomycescerevisiae DNA repair protein RAD23, and is tightly complexed withxeroderma pigmentosum group C(XPC), serving as a primary DNA damagesensor (Nord et al., 2000 Ann N Y Acad Sci 923:154-165). In E13.5 normalfetal lung, in situ hybridization demonstrated that Rad23b mRNA wasmainly detected in mesenchymal cells (FIG. 5A). At E16.5, the signal wasfound both in mesenchymal and bronchial epithelial cells (FIG. 5B). InTitf1-null mouse, the Rad23b expression was weakly detected in theepithelial layer of the trachea (FIG. 5C), but not in the lung (FIG.5E). SCGB3A2 treatment markedly induced the expression in the basallayer of the trachea (FIG. 5D) and mesenchymal cells of the lung (FIG.5F). Similarly, no Rad23b mRNA signal was detected in the ex vivocultured Titf1-null lung (FIG. 5G), which upon stimulation by SCGB3A2was highly induced in mesenchymal cells and weakly detected inepithelial cells (FIG. 5H). These results indicate that Rad23b likely isa SCGB3A2 downstream target that is responsible for proliferation ofTitf1-null lungs.

EXAMPLE 7 Effect of Decreased Expression of Rad23b on Ex Vivo LungDevelopment

This Example demonstrates phenotypic effects of knocking down Rad23bexpression.

In order to confirm that Rad23b is a SCGB3A2 downstream targetresponsible for lung development, the effect of knocking down Rad23bmRNA using specific siRNA on lung branching morphogenesis was examinedin ex vivo lung culture studies. First, Rad23b specific siRNA probeswere transfected into primary mesenchymal cells prepared from wild-typefetal lungs. Among four probes examined, two (designated 1 and 2)markedly decreased Rad23b mRNA levels to 2.8% and 6.2%, respectivelyrelative to control non-siRNA transfected cells (FIG. 6A). RT-PCR(reverse transcriptase PCR) analysis demonstrated that Rad23b expressionwas dramatically suppressed by probe 1, which was slightly recovered bythe addition of SCGB3A2 (FIG. 6B). Negative siRNA did not have anyeffect on Rad23b expression, and the level was enhanced by treatmentwith SCGB3A2.

Next, Rad23b siRNA probe1 was used for ex vivo culture studies of fetallungs (FIGS. 6C-H). Fetal lungs harvested at E11.5 and cultured for twodays with negative siRNA (e.g., random sequence siRNA that is notrelated to Rad23b) presented a similar degree of branching morphogenesisrespective to control lungs with and without SCGB3A2 (FIGS. 6E and 6Fvs. FIGS. 6C and 6D). In contrast, lungs treated with Rad23b siRNA probe1 were small and presented delayed branching morphogenesis as comparedwith lungs of control or treated with negative siRNA (FIG. 6G). Additionof SCGB3A2 to Rad23b siRNA-treated lungs demonstrated small effects, butled to clear advancement of branching as compared with Rad23b siRNA only(FIG. 6H vs FIG. 6G). This small recovery from the Rad23b siRNA-induceddelayed branching is in good agreement with the small increase by RT-PCRof Rad23b expression when cells were treated with Rad23b siRNA andSCGB3A2 together. These results demonstrate that SCGB3A2 inducedproliferation in fetal lungs, which is mediated through the Rad23bsignal.

EXAMPLE 8 SCGB3A2 Promotes Branching and Proliferation and Functions asa Growth Factor

This Example describes SCGB3A2's growth factor activities and effects onlung development.

As described herein, SCGB3A2 promotes branching and proliferation offetal lung, mediated through the downstream target Rad23b. This is thefirst report describing SCGB3A2 as a growth factor in addition to ananti-inflammatory agent, as was demonstrated using a mouse model forallergic airway inflammation (Chiba et al., (2006) Am. J. Respir. Crit.Care Med May 1; 173(9):958-64). This growth factor activity of SCGB3A2seems to be in accordance with the fact that expression of SCGB3A2 isfound at E11.5 and greatly increases by E16.5, during the period whenlung undergoes dramatic morphological changes.

SCGB3A2 was originally identified as a downstream target for TITF1 inlung using suppressive subtractive hybridization between wild-type andTitf1-null lungs (Niimi et al., (2001) Mol. Endocrinol. 15, 2021-2036).SCGB3A2 expression was directly regulated by TITF1 through its bindingto specific elements located in the promoter of SCGB3A2 gene (Niimi etal., (2001) Mol. Endocrinol. 15, 2021-2036). SCGB3A2 belongs to thesecretoglobin (SCGB) gene superfamily of small secretory proteins. Theprototypical protein of the SCGB gene superfamily, SCGB1A1, was proposedas a novel cytokine (Mukherjee et al., (1999) Cell Mol Life Sci 55,771-87). SCGB1A1 is highly expressed in the airways after E16.5throughout adulthood (Peri et al., (1995) J Clin Invest 96:343-353;Singh & Katyal (2000) Ann N Y Acad Sci 923:43-58) and is known toexhibit an anti-inflammatory function (Ye et al., (2004) Respiration71:505-510; Zhang et al., (1997) Science 276:1408-1412). In thiscontext, it is interesting to note that Scgb1a1-knockout mice exhibit noabnormalities in their lungs (Warburton et al., (2000) Mech Dev92:55-81).

Assuming that SCGB3A2 plays a role in lung development, it wasinteresting to examine whether SCGB3A2 is capable of recovering thedevelopment of Titf1-null lungs. As demonstrated herein, the arrest ofbranching and morphogenesis found in Titf1-null lungs is indeed partlyattributed to the deficiency of SCGB3A2. Thus, Titf1-null lung ex vivocultures exhibited dramatic morphological changes by the addition ofSCGB3A2 in the culture medium, presenting pleated and dentate epitheliallayers with increased mesenchymes. These morphological changes indicatethat SCGB3A2 induced proliferation and invagination, characteristicprocesses for branching (Minoo et al., (1999) Dev Biol 209:60-71; Kaplan(2000) Mol Genet Metab 71:321-341).

In in vivo experiments, no invagination was observed, which might be dueto low concentrations of SCGB3A2 protein that can reach the lung and/ordue to space constraint in the thorax. Nevertheless, the morphologicalchanges observed in SCGB3A2-stimulated Titf1-null lungs somewhatresemble those of tracheal development in Drosophila (Minoo et al.,(1999) Dev Biol 209:60-71; Kaplan (2000) Mol Genet Metab 71:321-341) inthat the epithelia in Titf1-null trachea and lung were almost barren,and after SCGB3A2 treatment, they became composed of ciliated columnarcells including goblet cells in the entire epithelia. Increasedexpression of proliferation markers, Ki-67 and phosphorylated histoneH3, demonstrated that SCGB3A2 induced proliferation in Titf1-null lung.The effect of SCGB3A2 on cell proliferation was further confirmed inwild-type fetal lung primary mesenchymal cells by BrdU incorporationexperiments. In support of this, increased expression of FGFs,particularly FGF7, was found in SCGB3A2-treated ex vivo Titf1-null fetallungs. This further indicates that epithelial cells proliferate in thepresence of SCG3A2 through FGF7 by epithelial-mesenchymal interaction(Wallach-Dayan et al., (2006) Am J Physiol Lung Cell Mol Physiol290:L790-L796; Ng et al., (2002) Mol Cell Biol 22:1233-1245).

MARCO (macrophage scavenger receptor with collagenous structure) wasreported as a SCGB3A2 receptor in human (Bin et al. (2003) J. Immunol.171, 924-30). MARCO is also known as a receptor for lipopolysaccharideand plays a role in inflammation (Budinger et al., (2006) Proc. Natl.Acad. Sci. U.S.A. 103:4604-4609). While the expression of MARCO wasfound in alveolar macrophages of adult mouse lung by in situhybridization as expected, the expression was not observed in E13.5fetal lungs as determined by either in situ hybridization orimmunohistochemistry. Further, treatment of wild-type primary fetal lungculture cells with excess SCGB3A2 protein gave positive signalspredominantly in the mesenchymal fraction of cells only withanti-histidine and anti-thioredoxin antibodies, but not anti-MARCOantibody, indicating that an unknown SCGB3A2-specific receptor likelyexists in fetal lungs, especially in mesenchyme.

DNA microarray analysis was carried out to understand what moleculesfunction through SCGB3A2 signaling in order to promote proliferation andbranching in fetal lungs. Among genes up-regulated, Rad23b was selectedfor further study as a candidate downstream target for SCGB3A2 becauseRad23b was mainly expressed in mesenchyme at early embryonic days. Micelacking the Rad23b gene, its homologue Rad23a, or both genes have beenestablished (Ng et al., (2003) Genes Dev 17:1630-1645; Katiyar et al.,(2005) Biochem Biophys Res Commun 337:1296-1300). Interestingly,Rad23b-null mice exhibit impaired embryonic development (Ng et al.,(2003) Genes Dev 17:1630-1645). Expression of the human RAD23B gene wasfound both in cytoplasm and nuclei during G1 phase and mainly incytoplasm during S phase (Lebeche et al., (1999) Mech Dev 86:125-136).

In the present disclosure, Rad23b expression was observed at E13.5 ofnormal fetal lungs, which increased by E16.5, coinciding with the stageof SCGB3A2 increase. SCGB3A2 also up-regulated Rad23b expression inTitf1-null lung ex vivo and in vivo. Further, Rad23b siRNA delayedbranching morphogenesis when examined by ex vivo organ culture studies;this delay was counteracted by the addition of SCGB3A2. Thiscounteraction, however, was not as effective as those of control ornegative siRNA in the presence of SCGB3A2. This could be due to acompetition between Rad23b siRNA and SCGB3A2 at the concentrations used.

In conclusion, disclosed herein is the discovery that SCGB3A2 is agrowth factor, playing a critical role in branching morphogenesis infetal lungs, whose activity is mediated through the DNA damage sensorgene Rad23b. SCGB3A2 is one of the major genes responsible for thephenotypes observed in the Titf1-null lungs. This growth factor activityof SCGB3A2 indicates that SCGB3A2 can be used to treat many lungdiseases such as asthma, chronic obstructive pulmonary disease, cancer,and neonatal respiratory distress.

EXAMPLE 9 Effect of SCGB3A2 on Bleomycin-Damaged DNA—Materials andMethods

This Example provides specific methods used for carrying out studiesusing SCGB3A2 to prevent or reverse lung damage caused by anti-canceragents such as bleomycin.

Animal Studies

For the bleomycin study, 7-8-week-old C57BL/6 female mice or SCGB3A2transgenic mice that over-express SCGB3A2 in lung, were intratracheallyintubated with bleomycin (8 U/kg of body weight; Sigma-Aldrich, St.Louis, Mo.) or PBS as control, or sham intubated at day 0, andeuthanized after 3 weeks. Some mice received SCGB3A2 intravenously for aweek starting day 1. All animal studies were carried out in accordancewith the Using Animals in Intramural Research Guidelines (NIH AnimalResearch Advisory Committee, NIH, Bethesda, Md.) after approval by theNCI Animal Care and Use Committee.

Cell Culture

Fetal lungs at E16.5 were incubated in DMEM/F12 containing 10% FBS, 1U/ml Dispase I (Roche Applied Science, Indianapolis, Ind.) and 1,000U/ml collagenase (Sigma-Aldrich) at 37° C. for 30 minutes with shaking.After incubation, cells were washed three times in DMEM/F12 containing10% fetal bovine serum (FBS). Cells were then plated onto a 10 cm-plateand incubated for 20 min at 37° C. to separate epithelial cells frommesenchymal cells (Lebeche et al., (1999) Mech Dev 86:125-136). Whilemesenchymal cells attached to the plates, epithelial cells that remainin the media were transferred to a new plate. Embryonic lung primaryculture cells were seeded on a 24-well plate at 3×10⁵ cells/ml fortransfection of siRNA or BrdU incorporation. Transfection was carriedout using HiPerFect Transfection Reagent (QIAGEN, Valencia, Calif.)according to the manufacturer's protocol.

For TUNEL assay (Promega, San Luis Obispo, Calif. USA) forbleomycin-damaged DNAs, primary fetal lung mesenchymal cells werecultured in LAB-TEK 8-chamber slides (Nalge Nunc International,Rochester, N.Y.) for 44 hours before the addition of bleomycin andharvested 20 hours later. SCGB3A2 was either added together with, or 20hours earlier than bleomycin addition.

Histological Analysis

Lungs were fixed in 4% paraformaldehyde (PFA) overnight at 4° C. andembedded in paraffin or O.C.T. Compound (SAKURA, Torrance, Calif.).TUNEL assay was performed to detect apoptotic cells in tissue sectionsusing commercially available kit (Promega, Madison, Wis.). Tissuesections were processed according to the manufacturer's instruction,through which a biotinylated nucleotide was incorporated at the 3′-OHend of fragmented DNAs. Biotin incorporation was detected with HRPconjugated streptavidin using DAB as a chromogen.

EXAMPLE 10

Effect of SCGB3A2 on Bleomycin-Damaged DNA

Bleomycin is well known for causing DNA damage and apoptosis (Povirk(1996) Mutat Res 355:71-89; Lee et al., (2005) Am J Physiol Lung CellMol Physiol 289:L521-528; Wang et al., (2000) Am J Physiol Lung Cell MolPhysiol 279:L143-151; Budinger et al., (2006) Proc. Natl. Acad. Sci.U.S.A. 103:4604-4609; Wallach-Dayan et al., (2006) Am J Physiol LungCell Mol Physiol 290:L790-L796). Since Rad23b was identified as acomponent of DNA damage sensor (Sugasawa et al., (1998) Mol Cell2:223-232), and as described herein SCGB3A2 exerts its proliferationactivity through Rad23b, it was proposed to determine if SCGB3A2 mayaffect the extent of bleomycin-induced DNA damage/apoptosis.

To this end, fetal lung primary mesenchymal cells were treated withbleomycin with and without SCGB3A2 (FIG. 8) and were subjected to TUNELassay. When SCGB3A2 was added to the culture media together withbleomycin, the number of TUNEL-positive cells clearly decreased to alevel one third above the control level (FIG. 8A), while pre-treatingcells with SCGB3A2 before addition of bleomycin completely suppressedbleomycin-induced DNA damage (FIG. 8B). In both cases, 250 ng ofHIS-SCGB3A2 was sufficient to repair and/or suppress DNA damage. Theseresults demonstrate that SCGB3A2 functions as (or mediates the functionof) a DNA repair anti-apoptotic agent.

EXAMPLE 11 SCGB3A2 Inhibits or Reduces Bleomycin-Induced PulmonaryFibrosis

This Example demonstrates that SCGB3A2 can be used to inhibit or reducelung damage caused by anti-cancer agents such as bleomycin.

Bleomycin, when given to mice by intratracheal intubation, producesinterstitial pneumonia and pulmonary fibrosis, which is used as a modelfor studying human interstitial pneumonia and pulmonary fibrosis(Polosukhin et al., (2005) Ultrastruct Pathol 29:53-64; Grande et al.,(1998) Scanning Microscopy 12:487-494). In order to examine the effectof SCGB3A2 on bleomycin-induced pulmonary fibrosis, wild-type mice aswell as SCGB3A2 transgenic mice over-expressing SCGB3A2 in lung underthe promoter of human surfactant protein C gene, were subjected to anexperimental model mouse for bleomycin-induced pulmonary fibrosis.

After bleomycin intubation, wild-type mice did not gain weight forseveral days, and although they gradually recovered, never reached theweights of control group of mice (FIG. 9A). After 3 weeks of bleomycinadministration, focal interstitial pneumonia with fibrosis andinflammation were observed in lungs of all bleomycin-treated mice (n=6)as determined by H & E staining, and Masson staining which detectscollagen fibers (FIGS. 9C, 9D), in contrast to PBS intubated controls(FIG. 9B). When mice were treated with SCGB3A2 for a week starting oneday after bleomycin treatment, most of mice presented normal lookinglungs with minor lesions of interstitial pneumonia with fibrosis (FIG.9E) and the presence of large macrophages (FIG. 9F), indicating that thelung had healed from the injury caused by bleomycin.

Next, SCGB3A2 transgenic mice were given bleomycin, and the changes inbody weight and tissue histology were compared with those of SCGB3A2transgenic and wild-type mice intubated with PBS, and wild-type miceintubated with bleomycin (FIG. 10). SCGB3A2 transgenic mice expressedmuch higher levels of SCGB3A2 in many alveolar Type II cells as comparedwith wild-type mice (FIG. 10C vs. 10B). SCGB3A2 transgenic mice did notlose any weight after bleomycin intubation, suggestive of no seriousdamage caused by bleomycin (FIG. 10A). In fact, all lungs ofbleomycin-intubated SCGB3A2 transgenic mice presented normal histology(n=5), similar to that seen in wild-type or SCGB3A2 transgenic micetreated with PBS (FIG. 10G, 10I vs. 10D, 10E). This is in sharp contrastto the lung histology of bleomycin-treated wild-type mice thatdrastically changed after 3 weeks of treatment as seen in FIG. 9 (FIG.10F, 10H vs. 10D). These results clearly demonstrate that SCGB3A2repairs bleomycin-induced DNA damage. Alternatively, the damage can becompletely suppressed by SCGB3A2 if present at high levels prior tobleomycin treatment.

Bleomycin is one of many anti-neoplastic agents that are known to induceDNA damage and apoptosis in lung, resulting in pulmonary fibrosis(Povirk (1996) Mutat Res 355:71-89; Lee et al.; (2005) Am J Physiol LungCell Mol Physiol 289:L521-528; Wang et al., (2000) Am J Physiol LungCell Mol Physiol 279:L143-151; Budinger et al., (2006) Proc. Natl. Acad.Sci. U.S.A. 103:4604-4609; Wallach-Dayan et al., (2006) Am J PhysiolLung Cell Mol Physiol 290:L790-L796). Although the involvement ofJUNK-dependent mitochondrial death pathway (Povirk (1996) Mutat Res355:71-89), caspase-8 and -9 (Wallach-Dayan et al., (2006) Am J PhysiolLung Cell Mol Physiol 290:L790-L796), and Bcl-2 family member Bid(Budinger et al., (2006) Proc. Natl. Acad. Sci. U.S.A. 103:4604-4609)has been suggested, the molecular mechanism for bleomycin-inducedapoptosis is poorly understood. As disclosed herein, SCGB3A2 functionsas an anti bleomycin-induced apoptosis reagent in vitro, and in a mousemodel for pulmonary fibrosis it can repair bleomycin-inducedinterstitial pneumonia and fibrosis. When SCGB3A2 was given prior tobleomycin or by high levels of SCGB3A2 expression such as found inSCGB3A2 transgenic mice, DNA damage by bleomycin did not occur,indicating that the SCGB3A2 signaling pathway may interact withbleomycin-induced apoptosis pathway. Thus, SCGB3A2 can intervene and/orsuppress pulmonary interstitial pneumonia and fibrosis.

EXAMPLE 12 Materials and Methods for Additional Bleomycin Experiments

This Example provides methods that were used to demonstrate that SCGB3A2inhibits or repairs existing lung damage caused by bleomycin.

Bronchoalveolar Lavage (BAL) Fluid and Cell Count

BAL fluid was obtained after mice were euthanized, by intratrachealinstillation of 1 ml PBS in the lung while it was kept located withinthe thoracic cavity. The lavage was reinfused in the lung two timesbefore final collection. BAL cells were isolated by centrifugation at3,000 rpm for 10 minutes, and resuspended in 20 μl PBS. Smearpreparation of BAL cells were stained with Diff-Quik Stain Set (DadeBehring Inc. Deerfield, Ill.). Cells in 2.25-6.5 cm² areas of smearpreparation (using 3-5 mice) were counted.

Histology

Masson trichrome staining to detect collagen fibers was carried outusing Accustain Trichrome Stains (Masson) (Sigma-Aldrich, St. Louis,Mo.) with slight modification.

EXAMPLE 13 SCGB3A2 Repairs Existing Bleomycin-Induced Lung Fibrosis

The effect of SCGB3A2 on bleomycin-induced DNA damage was examined usingprimary fetal lung mesenchymal cells in vitro and a mouse model forbleomycin-induced fibrosis in vivo. In both cases, SCGB3A2 repaired orsuppressed bleomycin-induced DNA damage/fibrosis when given together orprior to bleomycin treatment, respectively. Mice were intratracheallyadministered PBS or bleomycin; each group was further sub-grouped intothose that received intravenous injection of PBS or SCGB3A2 daily for aweek, starting at the 14th day of the experiment (total of 4 groups)(FIG. 11). All mice were subjected to euthanasia at the 21st day.Bronchoalveolar lavage fluid was collected for inflammatory cell countsand lung tissues were subjected to histological analysis includingMasson Trichrome staining that specifically stains for collagen fiber.

H&E stained whole lung tissues (n=5 in each group) were graded based onthe percentage of fibrous area (FIG. 12). Bleomycin-administered and PBSinjected group of mice (group 1) demonstrated up to 50% of fibrous areaswhich drastically diminished with statistical significance to almostnone in the bleomycin-administered and SCGB3A2 treated group (group 2),similar to those observed in PBS administered and PBS treated (group 3),and the PBS administered and SCGB3A2-injected group (group 4). MassonTrichrome staining of representative lungs from each group demonstratedhighly fibrous areas in group 1 lungs, whereas other groups of lungs(group 2-4) showed clean normal looking histology without traces offibrosis (FIG. 13). Bleomycin-treated mouse lungs already begin todevelop fibrosis after two weeks of treatment, which indicates thatSCGB3A2 has repaired fibrosis in group 2 mouse lungs.

Next, inflammatory cells in BAL fluid, which were increased as a resultof fibrosis and tissue damage, were counted in all groups of mice (FIG.14). Numbers of macrophages and neutrophils were dramatically decreasedin bleomycin-SCGB3A2-treated mice (group 2) as compared withbleomycin-PBS treated mice (group 1). Lymphocyte numbers were also lowerin the bleomycin-SCGB3A2-treated group of mice (group 2) as comparedwith the bleomycin-PBS treated mice (group 1). Group 3 and 4 mice hadlow levels of inflammatory cells in BAL fluid as expected. The resultsare in good agreement with the histology of bleomycin-SCGB3A2-treatedlungs that presented almost no fibrosis.

The present results demonstrate the striking effect of SCGB3A2 onrestoring normal histology of lungs that once had fibrosis. Previously,mice treated with SCGB3A2 daily for a week starting one day afterbleomycin administration or SCGB3A2 transgenic mice that over-expressSCGB3A2 in their airways, did not develop fibrosis after 3 weeks ofbleomycin administration. This is likely due to the fact that SCGB3A2suppresses apoptosis caused by bleomycin. This early phase effect ofSCGB3A2, however, appears to be different from the currently observedeffect where SCGB3A2 repaired bleomycin-induced lung fibrosis after ithas already begun.

The mechanisms for pulmonary fibrosis are not known. It is currentlybelieved that pulmonary fibrosis cannot be reversed once it has begun.However, as disclosed herein, SCGB3A2 can be used to treat pulmonaryfibrosis, particularly at the early stages of the disease. Thus, SCGB3A2may be given to cancer patients who undergo bleomycin chemotherapy inorder to reduce side effects and/or block bleomycin-induced fibrosis.

EXAMPLE 14 SCGB3A2 Promotes Lung Development In Vivo

This Example demonstrates that SCGB3A2, when administered to the mother,promotes lung development in pre-term mouse pups. The effect of SCGB3A2was examined on the late gestational stages of fetal lung development invivo by injecting highly purified tag-free, endotoxin-free SCGB3A2 dailyfrom E13.5 through E16.5 through the tail vein of pregnant female mice,followed by removal of pups from the mother at E17.5. Pups are usuallyborn at E19.0-20.0.

Pups removed at E17.5 from mothers receiving a total of 100 and 200 μgSCGB3A2 displayed similar body length (to each other), and body and lungweights, which were larger than PBS-treated control pups (FIG. 15A).Breathing scores (Ozdemir et al. (2003) Pediatr. Res. 53, 98-103) werealso statistically significantly higher among SCGB3A2-treated pups thanPBS controls. All lung function parameters obtained from the SCGB3A2-200treatment group were comparable to those from PBS-treated E19.0 pups. Inagreement with breathing scores, SCGB3A2-200-treated E17.5 lungs werewell air-inflated and had a similar appearance to that seen withPBS-treated Day 0 lungs, whereas PBS-treated E17.5 lungs did not appearto contain air (FIG. 15B). Further, histological examination revealedthat red blood cells were found inside immature alveolar walls ofPBS-treated E17.5 lungs, an observation normally obtained with thisgestational age of fetal lungs. In contrast, in SCGB3A2-treated lungs,red blood cells were already in contact with airways, indicative of thelung's ability to exchange air (FIG. 15C). In particular, the alveolarwalls of SCGB3A2-200-treated lungs were much thinner than PBS-treatedlungs, and some of alveolar space was fully extended, a phenotypetypically found in E19.0 normal fetal lungs.

The expression of several genes known to have markedly increasedexpression towards the end of gestation was examined by qPCR (FIG. 15D).Expression of surfactant protein (SP)-A and D (Ogasawara et al. (1991)Biochim. Biophys. Acta 1083, 252-6), aquaporin 1 (Horster (2000) Am. J.Physiol. Renal Physiol. 279, F982-96), and leptin receptor (Henson etal. (2004) Reproduction 127, 87-94; Cohen et al. (2005) J. Biol. Chem.280, 10034-9) genes were all significantly enhanced in E17.5 lungs uponSCGB3A2 treatment as compared with PBS, and the levels were similar toE19.0 control pups. Rad23b, which is likely to be a downstream targetfor SCGB3A2, also exhibited a similar expression pattern.

Finally, amniotic fluid lipidomes of the SCGB3A2-treated mice werecompared with those of immature E17.5 and mature E19.0 controls througha LC-MS-based metabolomic analysis (FIG. 15E). Examining the lipidcomposition of amniotic lipids has been widely used to predict fetallung maturity (Brown & Duck-Chong (1982) Crit. Rev. Clin. Lab. Sci. 16,85-159). A two-component model from unsupervised principal componentanalysis (PCA) showed that SCGB3A2-200 treatment led to the generationof lipid species similar to the mature control, whereas the lipidomeafter SCGB3A2-100 treatment was different from both immature E17.5 andmature E19.0 controls. Together, these results demonstrate that SCGB3A2promotes lung development in vivo.

Thus, administration of SCGB3A2 to a pregnant female mouse promoted lungdevelopment of preterm pups, which exhibited equivalent lung phenotypesto those of matured term pups. No obvious abnormality was noted with anyother organs/tissues of preterm pups, or in mothers treated withSCGB3A2. However, body length and weight were slightly increased inSCGB3A2-treated pups, in accordance with the increase of lung weight.Thus, without intending to be bound by theory, SCGB3A2 may be involvedin general pathways of growth promotion. Alternatively, there might be afactor(s) that sets a size of the body in order to accommodatedeveloping lung.

Because the limited volume of mouse amniotic fluid available preventedthe use of traditional thin-layer chromatography (Grenache & Gronowski,(2006) Clin. Biochem. 39, 1-10), a metabolomic approach that has beenadopted in other lipid-related research fields (Griffin & Nicholls(2006) Pharmacogenomics 7, 1095-107) was used to examine and compare thelipid profiles of amniotic fluid from control and SCGB3A2-treatedsamples. Distinctive grouping of immature and mature amniotic fluidsamples as well as the samples from SCGB3A2 treatments demonstrated thephenotyping capability of metabolomics on the fetal lung developmentbased on the lipid species in the amniotic fluid. In conclusion, theseresults demonstrate that SCGB3A2 is a powerful treatment for andpreventative of neonatal respiratory distress syndrome.

EXAMPLE 15 Treatment of Neonatal Respiratory Distress in Humans

This Example provides an exemplary protocol for the treatment ofneonatal respiratory distress in humans.

In particular, non-limiting examples, fetal administration isaccomplished by transplacental administration, for example byadministering the SCGB3A2 to the mother intravenously. Depending on thephysical condition of the mother and fetus, and on the length of timeavailable before the anticipated delivery, SCGB3A2 is administered in adose of from about 0.1 mg/kg to about 100 mg/kg of maternal weight. Inone specific, non-limiting example, an effective dose is from about 1mg/kg to about 20 mg/kg, or in even more particular examples, from about5 mg/kg to about 10 mg/kg of maternal weight.

The SCGB3A2 can be administered in a single dose, or in multiple doses,for example daily, during a course of treatment. In one embodiment,SCGB3A2 is administered as a single dose of from about 5 mg/kg to about10 mg/kg of maternal weight. In some instances, this single dose ofSCGB3A2 is sufficient to promote lung development such that, followingdelivery, the infant will have sufficiently mature lungs to breatheindependently.

In another embodiment, SCGB3A2 is administered as a series of pulsedoses during the course of treatment for as long as delivery can bedelayed. For instance, in some embodiments, SCGB3A2 is administered oncedaily until the time of delivery, or more frequently, for instance twicedaily or every 4 or 6 hours, for example.

In some embodiments, SCGB3A2 therapy is combined with glucocorticoidtreatment, which also speeds surfactant production. During the course oftreatment, lung maturity can continue to be monitored, until such timeas the lungs have matured and/or delivery can no longer be delayed. Ifneeded, in some embodiments, the newborn receives ex-utero SCGB3A2treatment and/or artificial surfactant to further promote lungmaturation and function. In many cases, however, in utero treatment withSCB3A2 is sufficient to promote lung maturity, even in very prematurebirths (for instance at 24 weeks or less), such that no furthertreatment is required.

EXAMPLE 16 Formulation of SCGB3A2 in a Nanoparticle-Based DeliverySystem

This Example provides exemplary protocols for producing ananoparticle-based drug delivery system for direct pulmonary delivery ofSCGB3A2. By way of example, the nanoparticles are made from gelatin, orpolybutylcyanoacrylate.

Production of Gelatin-Based Nanoparticles

Briefly, in one exemplary protocol, 1.25 g of gelatin B is dissolved in25 ml of distilled water and stirred at 600 rpm under constant heatingof 40° C. Twenty-five milliliters of acetone is added to the gelatinsolution. The high molecular weight gelatin is then precipitated fromthe solution. The supernatant containing low molecular size gelatinwhich is still soluble in the aqueous/organic solvent mixture is thendiscarded. The high molecular weight gelatin is then redissolved in 25ml of distilled water and stirred at 600 rpm under constant heating of40° C.; the pH of the solution is adjusted to 2.5 by adding 1N HCl; 75ml of acetone is added to the acidic gelatin solution drop-wise, and thenanoparticles are precipitated from the solution.

One hundred and twenty-five microliters of 1 mg/ml of solution of TexasRed in acetonitrile is added and stirred for 1 hour. The particles arestabilized using 400 μl of 25% glutaraldehyde as a cross-linking agent,and the suspension is left stifling for 12 hours without heating. Theremaining solvent is evaporated using a Rotavapor (for instance, IKA,Model RV 05, Staufen, Germany). The nanoparticles are purified bycentrifugation at 100,000×g (for instance, in a Beckman Model J2-21) for30 minutes, and are washed three times with distilled water. Theresulting particles are re-dispersed in 25 ml of distilled water. Thefluorescently-labeled nanoparticles are then stored at 4° C. andprotected from light.

Production of Polybutylcyanoacrylate-Based Nanoparticles

Briefly, in one exemplary protocol, polybutylcyanoacrylate nanoparticlesare prepared by an emulsion polymerization process described by Schereret al. (1993) J. Drug Target 1, 21-27. Fifty milligrams of FITC-Dextranis added to 10 ml of 0.01N HCl. The solution is stirred at 600 rpm; 100μl of the monomers are slowly added by pipette to the solution. Thesolution is then stirred for 4 hours and is protected from light; the pHis subsequently adjusted using 1N NaOH to pH 5.0. The particles are thenpurified from unbound dye and polymerization residuals as described forthe gelatin particles, above.

Nanoparticles are then suspended in 25 ml of distilled water aftercentrifugation, yielding 2 mg/ml of poly-cyanoacrylate nanoparticles.

Spray-Drying

To prepare inhalable nanoparticle powders, spray-drying is a commonlypracticed method (see, for instance, Bosquillon et al. (2001) J.Control. Release 70, 329-339; Mackin et al. (1997) Pharm. Sci. 3,583-586; Vanbever et al. (1999) Pharm. Res. 16, 1735-1742). Forspray-drying the nanoparticles (gelatin or polybutylcyanoacrylate), aMini-Spray Dryer produced by Büchi Laboratoriums-Technik (Flawil,Switzerland) or the equivalent is used. The Mini-Spray Dryer operates onthe principle of a nozzle spraying in a parallel-flow (the sprayedproduct and the drying air flow are in the same direction). Theadjustable parameters include inlet and outlet temperature, solutionpump flow rate, and the aspirator partial vacuum. In one exemplaryprotocol, the inlet air temperatures range from about 170 to 180° C.,the pump flow rate is about 2 ml/minute, the aspirator is set to 40m³/hour, and the atomizing air flow rate is about 700 l/hour (80 psi).The solution is pumped into the feeding system of the spray-dryer. Theresultant powder is then blown through the cyclone separator andcollected in a container. Exhaust air is extracted out of the cyclone bya vacuum pump and filtered using a fiber filter.

Five grams of SCGB3A2 are then dissolved in 75 ml of distilled water andheated up to 40° C. to increase the SCGB3A2 solubility. Then, thesolution is mixed with 25 ml of either gelatin nanoparticles orpolybutylcyanoacrylate nanoparticles. The glass chambers of the spraydryer are shielded from light. The powders are removed from thecollector vessel and stored at room temperature under light protection.

EXAMPLE 17 Growth of Lung Cells on Poly-DL-Lactic Acid Scaffolds

This Example describes an exemplary method of growing lung cells onpoly-DL-lactic acid scaffolds in order to engineer lung tissue fortransplant (see, for instance, Lin et al. (2006) J. BiomaterialsApplications 21, 109-118). Poly-DL-lactic acid (PDLLA) is a well-knownsuper-high molecular-weight acid that has good biocompatibility anddegrades following in vivo implantation (see, for instance, Lee &Gardella (2002) Analytical and Bioanalytical Chem., 373(7): 526-537). Inone exemplary protocol, either dense (non-porous) 2-D films and 3-D foamscaffolds of high porosity are used. Poly-DL-lactic acid films areprepared by dissolving 0.15 g of the polymer homogeneously in 3 mL ofdimethyl carbonate (DMC) at 50° C. This polymer—solvent mixture isapplied to circular glass coverslips (16 mm in diameter to fit into24-well cell culture plates) previously cleaned with acetone andalcohol. The coverslips are left at room temperature in a fume hood for48 hours to remove the solvent and then are immersed in distilled waterfor 24 hours. The PDLLA films are then peeled intact from the coverslipsand stuck to the base of the cell culture wells (24-well plates; forinstance, Triple Red, UK) using a small amount of DMC. The PDLLA foamsare prepared by thermal induced phase separation (TIPS) processing.Briefly, PDLLA with an inherent viscosity of 1.62 dL/g is used (forinstance, Purasorb, Purac Biochem, Goerinchem, The Netherlands). Thepolymer is dissolved in DMC to give a polymer weight to solvent volumeratio of 5%. The mixture is then stirred overnight to obtain ahomogeneous polymer solution. The solution is then transferred to alypholization flask, immersed in liquid nitrogen, and maintained at−196° C. for 2 hours. The frozen solution is then transferred into anethylene glycol bath at −10° C. and connected to a vacuum pump (10⁻²Torr). The solvent is sublimed at −10° C. for 48 hours and then at 0° C.for 48 hours. The foam samples are subsequently completely dried at roomtemperature in a vacuum oven until reaching a constant weight, forinstance, as determined using an electronic balance.

The multiwell plates containing films or foams are sterilized prior touse by exposure to UV light for 1 hour. The discs and foams arepreconditioned for 9 days in basal HITES medium (Invitrogen, Paisley,UK), which includes 50% Kaighn's modification of F-12 (F-12K), 50%Dulbecco's modified Eagle's medium (DMEM; LGC, UK) with an added 10%antibiotic/antimycotic (A/A) solution (Invitrogen, UK). The medium ischanged each day with a decreasing A/A concentration. Lung epitheliumcells, either from primary cultures or cell lines, are seeded at adensity of 2000 cells/cm² (a total of 4000 cells per well) on to thePDLLA films in 24-well plates and grown for 1-8 days or more in thepresence of 10 ng-10 mg/ml SCGB3A2, with the medium being changed eachday. The PDLLA foams are seeded with lung epithelial cells and culturedfor 1-8 days or more in the presence of 10 ng-10 mg/ml SCGB3A2, and themedium is changed each day. After the lung cells have grown to thedesired density/maturity, the foams are washed and transplanted into anarea of diseased or damaged lung tissue in a subject.

In view of the many possible embodiments to which the principles can beapplied, it should be recognized that the illustrated embodiments areonly examples and should not be taken as a limitation on the scope ofthe disclosure. Rather, the scope is in accord with the followingclaims. We therefore claim all that comes within the scope and spirit ofthese claims.

We claim:
 1. A method of inhibiting or reducing pulmonary fibrosiscaused by an anti-cancer agent in a subject, comprising: administering atherapeutically effective amount of murine or human SCGB3A2 to a murineor human subject, wherein the subject is a subject with pulmonaryfibrosis caused by an anti-cancer agent or is a subject who has begun orwill begin treatment with an anti-cancer agent that can cause pulmonaryfibrosis, thereby inhibiting or reducing pulmonary fibrosis caused bythe anti-cancer agent.
 2. The method of claim 1, wherein the SCGB3A2 isadministered intravenously, intra-arterially, intra-peritoneally,subcutaneously, or by inhalation.
 3. The method of claim 2, wherein theSCGB3A2 is administered by inhalation.
 4. The method of claim 3, whereinadministering the SCGB3A2 comprises use of an inhaler or nebulizer. 5.The method of claim 4, wherein the SCGB3A2 is formulated as ananoparticle.
 6. The method of claim 1, wherein the anti-cancer agent isa cytotoxic antibiotic.
 7. The method of claim 6, wherein the cytotoxicantibiotic is bleomycin.
 8. The method of claim 1, wherein the subjecthas pulmonary fibrosis caused by the anti-cancer agent.
 9. The method ofclaim 1, wherein administration of the SCGB3A2 to the subject increasespulmonary function in the subject.
 10. The method of claim 1, whereinadministration of the SCGB3A2 to the subject increases one or more ofinspiratory flow rate, expiratory flow rate, lung volume or oxygensaturation in the subject.
 11. The method of claim 1, further comprisingadministering an additional agent to the subject.
 12. The method ofclaim 11, wherein the additional agent is an anti-cancer agent, abronchodilator, an expectorant or a steroid.
 13. The method or claim 1,wherein the therapeutically effective amount of SCGB3A2 comprises about0.1 mg SCGB3A2 /kg bodyweight to about 100 mg SCGB3A2/kg bodyweight. 14.The method or claim 13, wherein the therapeutically effective amount ofSCGB3A2 comprises about 1 mg SCGB3A2/kg bodyweight to about 20 mgSCGB3A2/kg bodyweight.
 15. The method or claim 14, wherein thetherapeutically effective amount of SCGB3A2 comprises about 5 mgSCGB3A2/kg bodyweight to about 10 mg SCGB3A2/kg bodyweight.
 16. Themethod of claim 1, wherein the subject is being treated with theanti-cancer agent.
 17. The method of claim 16, wherein the SCGB3A2 isadministered in conjunction with the anti-cancer agent.
 18. The methodof claim 1, wherein the subject has begun or will begin treatment withan anti-cancer agent that can cause pulmonary fibrosis.